Successful Endoscopic Surgery Under Stereotactic Navigation for a Symptomatic Interhemispheric Arachnoid Cyst Without the Agenesis of the Corpus Callosum in an Elderly Patient: A Case Report

Abstract

BACKGROUND AND IMPORTANCE: In adults and elderly patients, most arachnoid cysts are asymptomatic. Interhemispheric arachnoid cyst (IHAC) is clinically rare. In this report, we describe a rare case of a symptomatic IHAC without the agenesis of the corpus callosum in an elderly patient who underwent stereotactic endoscopic neurosurgery with excellent results. CLINICAL PRESENTATION: An 85-year-old woman with multiple systemic complications presented with progressive left hemiparesis. MR images, including diffusion tensor images, at the initial examination showed a large IHAC in the right parietal region without the agenesis of the corpus callosum. The patient underwent 3 MR image scans over the next year, and the lesions were markedly enlarged. Endoscopic cyst fenestration using a stereotactic neuronavigation system was performed between the IHAC and the bilateral ventricles. Postoperatively, the IHAC was reduced to a size sufficient to improve her hemiparesis. CONCLUSION: This is the first report of successful stereotactic endoscopic neurosurgery for a symptomatic IHAC without the agenesis of the corpus callosum. Further experience is required to confirm the usefulness of this minimally invasive procedure.