World Neurosurg
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Quadrigeminal cistern arachnoid cysts (ACs) are usually asymptomatic, may be accidental findings during radiological evaluation, and are rare (5%-10% of all intracranial ACs). We report a case of type I quadrigeminal cistern AC managed via navigation-guided cystoventriculostomy followed by endoscopic third ventriculostomy (Video 1). A 0° rod-lens endoscope was used. ⋯ Pineal region ACs and associated hydrocephalus can be successfully treated with simple, minimally invasive endoscopic procedures. Navigation assistance may not be necessary in all cases, but it allows for safe, rapid location of the fenestration site. A minimally invasive route and attention to smaller nuances of anatomy are key to safe management of these benign conditions.