{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:19:34Z","timestamp":1740165574445,"version":"3.37.3"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T00:00:00Z","timestamp":1686009600000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 75-year-old man presented with bilateral lower limb weakness to our hospital from another clinic. Radiological examinations implied the possibilities of idiopathic normal pressure hydrocephalus (iNPH) and a suprasellar cyst, but both were observed conservatively at that time. Due to the progressive gait disturbance, a lumboperitoneal shunt was implanted 1 year later. The clinical symptoms improved, but the cyst had grown after another year, causing visual impairment. Transsphenoidal drainage of the cyst was performed, but delayed pneumocephalus occurred. Repair surgery was performed with temporary suspension of shunt function, but pneumocephalus relapsed two and a half months after the resumption of shunt flow. In the second repair surgery, the shunt was removed because it was assumed that it would prevent closure of the fistula by lowering intracranial pressure. Two and a half months later, after confirming involution of the cyst and no pneumocephalus, a ventriculoperitoneal shunt was implanted, and cerebrospinal fluid (CSF) leakage has not relapsed since then. The coexistence of idiopathic normal pressure hydrocephalus (iNPH) and Rathke's cleft cyst (RCC) is rare, but it can occur. RCC can be cured by simple drainage, but delayed pneumocephalus can occur in cases whose intracranial pressure decreases due to CSF shunting. When simple drainage without sellar reconstruction for RCC is attempted after CSF shunting for coexistent iNPH, attention should be paid to changes in intracranial pressure, and it is desirable to stop the flow of the shunt for a certain period.<\/jats:p>","DOI":"10.1055\/s-0043-1768573","type":"journal-article","created":{"date-parts":[[2023,6,6]],"date-time":"2023-06-06T23:39:19Z","timestamp":1686094759000},"page":"342-346","source":"Crossref","is-referenced-by-count":0,"title":["Refractory Delayed Pneumocephalus after Transsphenoidal Cyst Drainage for Rathke's Cleft Cyst in a Patient with a Cerebrospinal Fluid Shunt"],"prefix":"10.1055","volume":"18","author":[{"given":"Tetsuo","family":"Hashiba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8127-2635","authenticated-orcid":false,"given":"Masahiro","family":"Nonaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruka","family":"Iwamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takamasa","family":"Kamei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kansai Medical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,6,6]]},"reference":[{"first-page":"63","volume-title":"Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (3rd ed.): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus","author":"M Nakajima","key":"ref1"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S1474-4422(15)00046-0","article-title":"Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial","volume":"14","author":"H Kazui","year":"2015","journal-title":"Lancet 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Focus"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"425","DOI":"10.3171\/2017.4.JNS162451","article-title":"Identification and repair of intraoperative cerebrospinal fluid leaks in endonasal transsphenoidal pituitary surgery: surgical experience in a series of 1002 patients","volume":"129","author":"B A Strickland","year":"2018","journal-title":"J Neurosurg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s11102-017-0839-1","article-title":"Preoperative risk factors for postoperative complications in endoscopic pituitary surgery: a systematic review","volume":"21","author":"D J Lobatto","year":"2018","journal-title":"Pituitary"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s00701-020-04237-5","article-title":"Rathke's cleft cysts following transsphenoidal surgery: long-term outcomes and development of an optimal follow-up strategy","volume":"162","author":"H J Marcus","year":"2020","journal-title":"Acta Neurochir (Wien)"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4103\/ajns.AJNS_224_18","article-title":"Delayed Pneumoventricle following endonasal cerebrospinal fluid rhinorrhea repair with the coperitoneal shunt","volume":"14","author":"S S Krishnan","year":"2019","journal-title":"Asian J Neurosurg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jocn.2015.12.041","article-title":"Rathke's cleft cyst: a case report of recurrence and spontaneous involution","volume":"32","author":"Z Rasmussen","year":"2016","journal-title":"J Clin Neurosci"}],"container-title":["Asian Journal of 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