Cyst-ventricular shunt by neuroendoscopic approach.First case of its kind in Guyana

Resumo

Arachnoid cysts are benign extracerebral collections formed by cerebrospinal fluid surrounded by an arachnoid membrane that is histologically indistinguishable from the healthy arachnoid. Its etiology the most widely accepted hypothesis is the embryonic one according to which they are produced by a dysgenesis in the embryological development of the subarachnoid space. In this clinical case we present a 24-year-old patient of Venezuelan origin, currently living in Guyana, who presents generalized tonic clonic seizures and after imaging studies showed a giant arachnoid cyst in the right temporal region, therefore we performed an endoscopic approach with the aim of creating a communication from the cyst to the ventricular system. To perform the surgical procedure, which consisted of performing an endoscopic cyst-ventricular shunt, a rigid Karls Storz endoscope with 30- degree optics was used, during the surgery we had several challenging questions that were resolved despite the unusual nature of the procedure, in terms of the selection of the approach site and despite all the anatomical inconveniences and the agreed planning contrary to what is usually done in most cases, the results were satisfactory. The post-surgical evolution of our patient was really satisfactory, no immediate or late complications were observed, no sequelae related to surgery were observed.