Aliasgar V Moiyadi1, Prakash M Shetty. 1. Department of Surgical Oncology, Neurosurgical Services, Tata Memorial Hospital, Mumbai, India. aliasgar.moiyadi@gmail.com
Abstract
BACKGROUND: Various treatment modalities are available for treatment of cystic lesions of the brainstem. However, cyst refilling and recurrences are very common. This article describes a young boy who presented with an intra-axial brainstem cyst following radiation for a pilocytic astrocytoma. METHODS: The cyst was decompressed surgically once but it soon refilled. The use of a novel customized synthetic sponge acting as a shunt for the treatment of a cystic brainstem lesion is discussed. The sponge was fashioned like a dumbbell and inserted across the fenestration in the cyst wall. RESULTS: The dumbbell design made it self-retaining. The characteristics of the sponge permitted continuous capillary drainage, with a low risk of occlusion. There was a dramatic decrease in the cyst size on follow-up scans, with resolution of clinical deficits. CONCLUSIONS: A customized sponge shunt can serve as an easily available and effective internal shunt for intra-axial craniospinal cysts.
BACKGROUND: Various treatment modalities are available for treatment of cystic lesions of the brainstem. However, cyst refilling and recurrences are very common. This article describes a young boy who presented with an intra-axial brainstem cyst following radiation for a pilocytic astrocytoma. METHODS: The cyst was decompressed surgically once but it soon refilled. The use of a novel customized synthetic sponge acting as a shunt for the treatment of a cystic brainstem lesion is discussed. The sponge was fashioned like a dumbbell and inserted across the fenestration in the cyst wall. RESULTS: The dumbbell design made it self-retaining. The characteristics of the sponge permitted continuous capillary drainage, with a low risk of occlusion. There was a dramatic decrease in the cyst size on follow-up scans, with resolution of clinical deficits. CONCLUSIONS: A customized sponge shunt can serve as an easily available and effective internal shunt for intra-axial craniospinal cysts.