RESUMO
The article describes a case of successful treatment of cerebral aneurysm with a flow-diverting stent using the temporary assist device Comaneci (Rapid Medical, Yokneam, Israel). Clinical symptoms and methods of instrumental diagnostic for cerebral aneurysm are presented. Endovascular management technique is described in detail. Flow diversion has become a widely accepted treatment option for intracranial aneurysms, especially those with a wide neck. However, a complication of this procedure is incomplete stent expansion. This clinical case describes resolving the incomplete flow divertor expansion using the controllable temporary assistance device Comaneci.
RESUMO
OBJECTIVE: Congenital arachnoid cysts in the middle fossa accounts for 50% of all intracranial arachnoid cysts. Several management options have been described; however, no single technique has been universally adopted. We describe a series of pediatric patients with middle cranial fossa arachnoid cyst that were treated through an innovative minimally invasive endoscopic technique, along with their clinical aspects and surgical outcomes. METHODS: Data from 65 patients operated between 2012 and 2018 were retrospectively analyzed. Follow-up ranged from 12 to 96 months. Clinical presentation and surgical outcomes were collected. Endoscopic cystocisternostomy was performed in all patients using a mini endoscope. RESULTS: There were 41 male and 24 female patients, with a mean age of 5.3 years at the time of treatment. Except for 4 patients, all presented with 1 or more symptoms, and the most frequent were intracranial hypertension signs. All patients were treated with the same surgical technique, with an efficacy of 81.5%. CONCLUSIONS: Using a mini endoscope allow us to perform multiple fenestrations along the arachnoid and deeply inspect the basal cisterns, achieving a much wider communication between the cyst and subarachnoid space with a high success rate and minimal invasiveness.