Approach and presentation of quadrigeminal cistern arachnoid cyst in pediatrics: a case series Abordaje y presentación del quiste aracnoideo de la cisterna cuadrigeminal en pediatría: una serie de casos

Abstract

Quadrigeminal cisternal arachnoid cysts (QACs) represent a rare group of central nervous system lesions. They occur between the collicular plates and the notch of the free edge of the tentorium. The clinical picture depends on the extent and severity of compression on the brainstem, the lamina quadrigemina on the cerebellum, and the aqueduct of Sylvius. QACs account for 5% to 10% of all intracranial arachnoid cysts and are often diagnosed incidentally through a brain CT or MRI study. There is no consensus on the treatment for these types of cysts. They can be approached through a craniotomy and fenestration of the lesion or cystoperitoneal shunt. An endoscopic third ventriculostomy or ventriculoperitoneal shunt can be performed in case of hydrocephalus. Neuroendoscopy represents a practical, minimally invasive approach for this type of cyst. A retrospective review of institutional cases with a diagnosis of symptomatic QACs between January 2017 and April 2024 was performed. Medical records were reviewed, and patient data and information on admission, evolution, examinations, postoperative course, and follow-up after discharge were collected.