case_images: PMC5820883_01
case_images: Sagittal and axial magnetic resonance imaging T1-Weighted showed a dilated fourth ventricle due to an arachnoid cyst causing tri-ventricular hydrocephalus with trans-ependymal cerebrospinal fluid resorption
case_images: AJNS-13-184-g002.jpg
case_images: PMC5820883_01_AJNS-13-184-g002.jpg
case_images: F1
case_images: An urgent brain CT scan followed by MRI showed a dilated fourth ventricle due to an AC causing tri-ventricular hydrocephalus with trans-ependymal CSF resorption [Figure 1].
case_images: Sagittal and axial magnetic resonance imaging T1-Weighted showed a progressive reduction in size of the cyst and aqueduct as well as of the ventricular cavities
case_images: AJNS-13-184-g003.jpg
case_images: PMC5820883_01_AJNS-13-184-g003.jpg
case_images: F2
case_images: Brain MRI checks at 2, 6, and 12 months showed a progressive reduction in the size of the cyst and aqueduct as well as of the ventricular cavities [Figure 2].
case_images: Linear (1.5 cm) right frontal incision placed anteriorly on a frontal wrinkle or along the hairline
case_images: AJNS-13-184-g004.jpg
case_images: PMC5820883_01_AJNS-13-184-g004.jpg
case_images: F3
case_images: The operative approach consists of a linear (1.5 cm) right frontal incision placed rather anteriorly, possibly along the hairline [Figure 3], to easily direct the endoscope toward the posterior portion of the third ventricle and aqueduct.
case_images: Endoscopic photos showing cyst fenestration/marsupialization and third ventriculostomy
case_images: AJNS-13-184-g005.jpg
case_images: PMC5820883_01_AJNS-13-184-g005.jpg
case_images: F4
case_images: The cyst is identified and after visual inspection, a careful coagulation of its surface is performed aiming for as large a fenestration as possible, completed by forceps [Figure 4].