Multidisciplinary approach to the prenatal diagnosis and post natal management of a large suprasellar arachnoid cyst: a case report.

Omar Irfan, Aga Khan University
Heera Nand, Aga Khan University
Sarfraz Karim, Aga Khan University
Shabina Arif, Aga Khan University
Aneela Darbar, Aga Khan University

Abstract

Abstract

Arachnoid cysts are intra-arachnoid sacs filled with cerebrospinal fluid representing a rare occurence in neonates. We report the case of a suprasellar arachnoid cyst diagnosed prenatally at 21 weeks gestation on routine obstetric ultrasound. A cystic lesion was picked up incidentally at routine antenatal scan. The cyst was noted to be increasing in size over a series of radiological scans. The cyst was diagnosed as a suprasellar arachnoid cyst compressing the third ventricle and bilateral lateral ventricles. A left pteryonal craniotomy for cystocisternostomy of large suprasellar cyst was performed initially. Within a month the cyst recurred with clinical and radiological evidence. An Endoscopic Third Ventriculostomy (ETV) with fenestration was performed.The patient was shifted to the NICU and discharged after 3 days in a stable condition. Patient was followed after 1 week and reassured and advised for one year follow-up.