{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:26:31Z","timestamp":1787099191714,"version":"build-2736575974"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,8,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Arachnoid cysts (ACs) are collections of CSF within an arachnoid membrane. Suprasellar ACs (SACs) constitute 1%\u20139% of all ACs, with giant SACs representing a rarer subset at increased risk of rupture, intracranial hemorrhage, and neurological deficits. While ventriculostomy is well characterized, anatomical considerations and technical nuances of cystocisternostomy remain limited; adult presentation and outcomes remain poorly defined. The authors describe surgical technique and postoperative outcomes in 2 adult patients undergoing endoscopic ventriculocystocisternostomy for giant SACs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>Both cases were managed with endoscopic transventricular ventriculocisternostomy. Intraoperatively, an absent tuber cinereum allowed for cyst wall fenestration under direct visualization. The first case was a 33-year-old male with bitemporal hemianopsia, headaches, and memory loss. He experienced significant improvement in his bitemporal hemianopsia and resolution of headaches at 1 year. The second case was a 36-year-old female with debilitating daily headaches, which decreased to one or two episodes per week at 5 months postoperatively. Follow-up imaging demonstrated decreased cyst size and mass effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Giant ACs warrant closer surveillance and often surgery due to higher risks of deficits. Careful anatomical orientation and controlled dual fenestration are key to achieving durable decompression. Endoscopic ventriculocisternostomy is a feasible and effective approach for symptomatic SACs.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26372\">https:\/\/thejns.org\/doi\/10.3171\/CASE26372<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26372","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:59Z","timestamp":1787097659000},"source":"Crossref","is-referenced-by-count":0,"title":["Technical nuances of endoscopic transcortical transventricular fenestration for management of giant suprasellar arachnoid cysts in adults: illustrative cases"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2425-7927","authenticated-orcid":true,"given":"Matthieu D.","family":"Weber","sequence":"first","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Mamaril-Davis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9750-6283","authenticated-orcid":true,"given":"Mark A.","family":"Damante","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Vignolles-Jeong","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8365-8032","authenticated-orcid":true,"given":"Guilherme","family":"Finger","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0009-5049","authenticated-orcid":true,"given":"Kyle C.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Columbus, Ohio"},{"name":"The James Cancer Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-2339","authenticated-orcid":true,"given":"Daniel M.","family":"Prevedello","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Columbus, Ohio"},{"name":"The James Cancer Center, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"J Neurosurg","first-page":"222","article-title":"Prevalence and natural history of arachnoid cysts in adults","volume":"118","author":"Al-Holou","year":"2013","unstructured":"Al-Holou WNTerman SKilburg CGarton HJMuraszko KMMaher CO.Prevalence and natural history of arachnoid cysts in adults. 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