{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:38:47Z","timestamp":1789231127659,"version":"build-2803163510"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"<jats:p>Arachnoid cysts of the fourth ventricle are rarely reported. Management options include CSF diversion, cyst fenestration, or cyst excision. Fenestration can be done via open microsurgical technique or endoscopically with or without simultaneous third ventriculostomy; and both rigid and flexible endoscopy have been used successfully. However, application of this treatment modality in pediatric patients is not well described. Therefore, to their knowledge, the authors report the first successful treatment of a fourth ventricular arachnoid cyst with a single frontal burr hole entry point for third ventriculostomy and fourth ventricular arachnoid cyst fenestration performed using flexible neuroendoscopy. The patient was a 13-month-old boy presenting with progressive macrocephaly. The authors review their technique, discuss special considerations when using this approach, and include an annotated intraoperative video for demonstration to help instruct and guide management. The authors demonstrate with an example that a single frontal burr hole entry point for flexible endoscopic third ventriculostomy and navigation through a dilated cerebral aqueduct for fourth ventricular arachnoid cyst fenestration is a viable treatment for symptomatic fourth ventricular arachnoid cysts in children.<\/jats:p>","DOI":"10.3171\/2022.12.peds22437","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T13:58:19Z","timestamp":1676037499000},"page":"391-396","source":"Crossref","is-referenced-by-count":4,"title":["Flexible neuroendoscopy for endoscopic third ventriculostomy and fourth ventricular arachnoid cyst fenestration in an infant"],"prefix":"10.3171","volume":"31","author":[{"given":"Luis","family":"Fernandez","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;"},{"name":"Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"LoPresti","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;"},{"name":"Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"DeCuypere","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;"},{"name":"Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandi K.","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois;"},{"name":"Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"18","key":"b1","series-title":"N Engl J Med","first-page":"1821","article-title":"Incidental findings on brain MRI in the general population","volume":"357","author":"Vernooij MW","year":"2007","unstructured":"Vernooij MW, Ikram MA, Tanghe HL,  Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821\u20131828.17978290"},{"issue":"4","key":"b2","series-title":"Neuroradiology","first-page":"341","article-title":"Do arachnoid cysts grow? 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