{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:20:13Z","timestamp":1767921613071,"version":"3.49.0"},"reference-count":43,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Posterior fossa cysts are usually divided into Dandy-Walker malformations, arachnoid cysts, and isolated and\/or trapped fourth ventricles. Shunt placement is a mainstay treatment for decompression of these fluid collections when their expansion becomes symptomatic. Although several techniques to drain symptomatic posterior fossa cysts have been described, each method carries its own advantages and disadvantages. This article describes an alternative technique.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In 10 patients, the authors used an alternative technique involving stereotactic and endoscopic methods to place a catheter in symptomatic posterior fossa cysts across the tentorium. Discussion of these cases is included, along with a review of various approaches to shunt placement in this region and recommendations regarding the proposed technique.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>No patient suffered intracranial hemorrhage related to the procedure and catheter implantation. All 3 patients who underwent placement of a new transtentorial cystoperitoneal shunt and a new ventriculoperitoneal shunt did not suffer any postoperative complication; a decrease in the size of their posterior fossa cysts was evident on CT scans obtained during the 1st postoperative day. Follow-up CT scans demonstrated either stable findings or further interval decrease in the size of their cysts. In 1 patient, the postoperative head CT demonstrated that the transtentorial catheter terminated posterior to the right parietal occipital region without entering the retrocerebellar cyst. This patient underwent a repeat operation for proximal shunt revision, resulting in an acceptable catheter implantation. The patient in Case 8 suffered from a shunt infection and subsequently underwent hardware removal and aqueductoplasty with stent placement. The patient in Case 9 demonstrated a slight increase in fourth ventricle size and was returned to the operating room. Exploration revealed a kink in the tubing connecting the distal limb of the Y connector to the valve. The Y connector was replaced with a T connector, and 1 week later, CT scans exhibited interval decompression of the ventricles. This patient later presented with cranial wound breakdown and an exposed shunt. His shunt hardware was removed and he was treated with antibiotics. He later underwent reimplantation of a lateral ventricular and transtentorial shunt and suffered no other complications during a 3-year follow-up period.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The introduction of endoscopic and stereotactic techniques has expanded the available treatment possibilities for posterior fossa cysts.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.4.peds10541","type":"journal-article","created":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T14:03:40Z","timestamp":1309529020000},"page":"15-21","source":"Crossref","is-referenced-by-count":10,"title":["A novel method for stereotactic, endoscope-assisted transtentorial placement of a shunt catheter into symptomatic posterior fossa cysts"],"prefix":"10.3171","volume":"8","author":[{"given":"Michael S.","family":"Turner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ha Son","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troy D.","family":"Payner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron A.","family":"Cohen-Gadol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0080015","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1159\/000121277","article-title":"ISG viewing wand-guided endoscopic catheter placement for treatment of posterior fossa CSF collections","volume":"27","author":"Arginteanu","year":"1997"},{"key":"b2-0080015","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s003810050396","article-title":"Endoscopic approach to arachnoid cyst","volume":"15","author":"Choi","year":"1999"},{"issue":"1 Suppl","key":"b3-0080015","series-title":"J Neurosurg","first-page":"21","article-title":"Endoscopic aqueductoplasty and placement of a stent in the cerebral aqueduct in the management of isolated fourth ventricle in children","volume":"104","author":"Cinalli","year":"2006"},{"key":"b4-0080015","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s003810050031","article-title":"Complications after shunting isolated IV ventricles","volume":"13","author":"Eder","year":"1997"},{"key":"b5-0080015","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/02688699944122","article-title":"Posterior fossa arachnoid cysts","volume":"13","author":"Erdin\u00e7ler","year":"1999"},{"key":"b6-0080015","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/jns.1985.63.2.0210","article-title":"Infratentorial arachnoid cysts","volume":"63","author":"Galassi","year":"1985"},{"key":"b7-0080015","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1055\/s-2001-13588","article-title":"Endoscopic surgery for large posterior fossa arachnoid cysts","volume":"44","author":"Gangemi","year":"2001"},{"key":"b8-0080015","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"778","DOI":"10.3171\/jns.2005.103.5.0778","article-title":"Endoscopic aqueductoplasty through a tailored craniocervical approach","volume":"103","author":"Gawish","year":"2005"},{"issue":"1 Suppl","key":"b9-0080015","series-title":"Neurosurgery","first-page":"E206","article-title":"Endoscopic aqueductal stenting via the fourth ventricle under navigating system guidance: technical note","volume":"56","author":"Hamada","year":"2005"},{"key":"b10-0080015","series-title":"Childs Nerv Syst","first-page":"710","article-title":"Management strategies for treatment of the trapped fourth ventricle","volume":"20","author":"Harter","year":"2004"},{"key":"b11-0080015","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1055\/s-2000-11377","article-title":"Clinical features in patients requiring reoperation after failed endoscopic procedures for hydrocephalus","volume":"43","author":"Hayashi","year":"2000"},{"key":"b12-0080015","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"515","DOI":"10.3171\/jns.1984.61.3.0515","article-title":"The Dandy-Walker malformation. 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