The most successful surgical management of periventricular and intraventricular cysts is still a matter of debate. Up to the early 1990s, open cyst fenestration and cystoperitoneal shunts were the only options available. Recently, different endoscopic approaches to these lesions have gained popularity. Eighteen endoscopic procedures were performed for the treatment of arachnoid cysts in 18 patients. Sylvian fissure arachnoid cysts were excluded from this study. Ten of them were females and eight were males with their ages ranging from 6 months to 50 years with a mean of 16 years. All patients were prospectively observed. Seven of the arachnoid cysts were in the suprasellar region, 5 in the quadrigeminal region, 2 in the posterior fossa, 2 parietal, and 2 intraventricular. Seventeen cases (94%) had hydrocephalus. The main presenting manifestations were those of increased intracranial pressure. All fenestrations were done in the lateral ventricle except for the 2 cases with posterior fossa arachnoid cysts, the fenestrations were done to the fourth ventricle. Endoscopic ventriculocytostomies (VC) were performed in 14 cases without operative complications and no stents were placed. Endoscopic cystocisternostomies (C) were done in all suprasellar cases. Endoscopic cystoventriculostomies (CV) were done in 4 cases. The mean surgical time was 1 h. The mean follow-up period was 15 months. Symptoms improved in 17 cases. Seventeen cases demonstrated a significant decrease of the cysts’ size in the postoperative computed tomography (CT) and magnetic resonance imaging (MRI). A single case developed a complication in the form of subdural hygroma which required no intervention and was managed conservatively. Endoscopic management of periventricular and intraventricular arachnoid cysts is a useful safe option in the management of arachnoid cysts related to the ventricular system.

中文翻译：

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脑室周围和脑室内蛛网膜囊肿的内镜治疗

脑室周围和脑室内囊肿最成功的手术治疗仍然存在争议。直到 1990 年代初期，开放性囊肿开窗术和膀胱腹腔分流术是唯一可用的选择。最近，针对这些病变的不同内窥镜方法越来越受欢迎。18 名患者接受了 18 次内窥镜手术治疗蛛网膜囊肿。本研究排除了外侧裂蛛网膜囊肿。其中女性10人，男性8人，年龄6个月至50岁，平均16岁。所有患者均接受前瞻性观察。蛛网膜囊肿 7 个在鞍上区，5 个在四叉神经区，2 个在后颅窝，2 个顶叶和 2 个脑室内。17 例 (94%) 有脑积水。主要表现为颅内压增高。除2例后颅窝蛛网膜囊肿均在第四脑室开窗外，其余均在侧脑室开窗。14例行内窥镜脑室细胞造口术（VC），无手术并发症，未放置支架。所有鞍上病例均进行了内窥镜膀胱胆管造口术 (C)。4 例行内窥镜膀胱脑室造口术 (CV)。平均手术时间为1小时。平均随访期为 15 个月。17 例症状改善。17 个病例在术后计算机断层扫描 (CT) 和磁共振成像 (MRI) 中显示囊肿大小显着减小。单个病例出现了硬膜下湿疹形式的并发症，无需干预并保守治疗。脑室周围和脑室内蛛网膜囊肿的内镜治疗是治疗与脑室系统相关的蛛网膜囊肿的一种有用的安全选择。