• World Neurosurg · Nov 2018

    Case Reports

    Glimpse into Pathophysiology of Sellar Arachnoid Cysts.

    • Mendel D Castle-Kirszbaum, Brent Uren, James King, Yi Yuen Wang, and Tony Goldschlager.
    • Department of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. Electronic address: mendel.dck@gmail.com.
    • World Neurosurg. 2018 Nov 1; 119: 381-383.

    BackgroundSellar arachnoid cysts are a rare occurrence but may impinge on vital parasellar anatomy and thus are often symptomatic. The etiology of sellar arachnoid cysts is contentious, fueled by heterogeneity in cyst wall structure and contents between cases. The "ball-valve" mechanism is 1 of 2 predominant theories describing their formation, which contends that an aperture in the diaphragm allows cerebrospinal fluid to enter the cyst, propelled by pulsatile flow, but its egress is obscured by the pituitary during the ebb of the pressure wave.Case DescriptionHere we present a case of a 51-year-old female with a symptomatic sellar arachnoid cyst. She underwent an endoscopic transsphenoidal fenestration which alleviated her symptoms.ConclusionsIntraoperative video evidence during arachnoid cyst fenestration supports the "ball-valve" theory of sellar arachnoid cyst development.Copyright © 2018 Elsevier Inc. All rights reserved.

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