{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:34:52Z","timestamp":1773398092090,"version":"3.50.1"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Quadrigeminal cistern arachnoid cysts are rare in adults, but can cause reversible gait and cognitive impairment secondary to obstructive hydrocephalus. Differentiating these structural lesions from idiopathic normal-pressure hydrocephalus (iNPH) or neurodegenerative diseases is essential because they are surgically treatable.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 71-year-old woman presented with progressive gait disturbance and mild cognitive impairment. Neuropsychological tests showed a Montreal Cognitive Assessment\u2013Japanese version (MoCA-J) score of 21\/30 and a frontal assessment battery (FAB) score of 13\/18, indicating executive dysfunction. Standard cognitive screening such as mini-mental state examination did not detect the subtle deficits identified by MoCA. Magnetic resonance imaging revealed a giant arachnoid cyst in the quadrigeminal cistern compressing the midbrain and cerebral aqueduct, resulting in obstructive hydrocephalus. Endoscopic cyst fenestration was performed through a right frontal burr hole. The cyst was opened and communication with the third ventricle was achieved. Gait and cognitive functions markedly improved postoperatively (MoCA-J 26\/30, FAB 17\/18) and radiographic findings showed that the hydrocephalus had resolved. Ocular symptoms, including difficulty gazing upward, also resolved after surgery.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Quadrigeminal cistern arachnoid cysts can mimic iNPH or neurodegenerative disorders, but represent a reversible cause of cognitive and gait impairments. Detailed neuroimaging and sensitive cognitive assessments are essential for diagnosis. Neuroendoscopic fenestration provides a treatment, i.e., minimally invasive and effective, even in elderly patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1275_2025","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:02:53Z","timestamp":1773392573000},"page":"142","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reversible cognitive and gait impairment by a giant quadrigeminal cistern arachnoid cyst: A case report of marked reversal following neuroendoscopic fenestration"],"prefix":"10.25259","volume":"17","author":[{"given":"Toshihide","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoyuki","family":"Yanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Tamaoka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tsukuba Memorial Hospital, Tsukuba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saaya","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Aiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiki","family":"Marushima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"10.25259\/SNI_1275_2025\/ref-1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.4103\/neuroindia.NI_934_15","article-title":"Do the clinicoradiological outcomes of endoscopic fenestration for intracranial cysts count on age? 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