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Objective: The traditional treatment of sellar Rathke cleft cysts (RCCs) generally involves transsellar drainage; however, suprasellar RCCs present unique challenges to appropriate management and technical complexity. Reports on overall outcomes for the endoscopic endonasal approach (EEA) for this pathology are limited. The EEA for RCCs allows three surgical techniques: marsupialization, fenestration, and fenestration with cyst wall resection.

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Objectives: Prenatally diagnosed complex arachnoid cysts are very rare. While the true prenatal incidence is still unknown, they account for approximately 1% of intracranial masses in newborns. They rarely exhibit rapid growth or cause obstructive hydrocephalus, but if they increase to such a dimension during pregnancy, the ideal management is not well established.

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Background: The petroclival area is a technically challenging region to operate owing to the proximity of the internal carotid artery (ICA) and the need to obtain gross total excision of tumors in this area as they are often resistant to radiotherapy.

Objective: We present our experience with the endonasal endoscopic transpterygoid approach in managing tumors of the petroclival region and discuss various operative nuances for safer resection.

Materials And Methods: A retrospective study of all consecutive cases of lesions occupying the petroclival region that were operated via endonasal endoscopic transpterygoid approach at our center between January 2016 and December 2021 was performed.

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Article Synopsis
  • - A 32-year-old male experienced progressive lower limb weakness and spastic paraparesis due to an intramedullary arachnoid cyst (IMAC), prompting a case report and a review of related literature involving 26 patients from 23 articles.
  • - IMACs generally occur in two age groups: under 10 years and over 30 years, but should still be considered in the differential diagnosis of intramedullary cystic lesions, even if rare.
  • - The authors recommend early surgical intervention for symptomatic IMACs, emphasizing the importance of resecting the cyst wall and suggesting laminoplasty for younger patients to prevent long-term deformities; they call for further long-term studies to refine treatment
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