UNASSIGNED: Multiple arachnoid cysts are very rare within the central nervous system. The cysts will sometimes increase in size with age, lead to the mass effect or cerebrospinal fluid (CSF) flow obstruction, and cause some symptoms, which requires the surgery intervention.
UNASSIGNED: A 35-year-old female was admitted to our hospital with some symptoms related to hydrocephalus for 1 month. Brain magnetic resonance imaging (MRI) revealed well-marginated cystic lesions with CSF signal intensity in the ventricular and cisternal systems, bilateral temporal lobes, and left occipital lobe. Cine phase-contrast MRI showed the aqueduct of sylvius was blocked by the cyst in the quadrigeminal cistern. We employed endoscopic ventriculocystostomy and septostomy to create the communication of the cyst with ventricular and cistern system. As a result, the patient\'s symptoms were relieved.
UNASSIGNED: Endoscopic management can be an effective way for treating intracranial multiple arachnoid cysts, which is the first report of this kind. We hope that this report could help improve the management of intracranial arachnoid cysts with the neuroendoscopic technology.

OBJECTIVE: Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) are 2 surgical methods used for the treatment of obstructive hydrocephalus. However, the efficacy and safety of these 2 procedures are unknown. Therefore we conducted a meta-analysis to compare the safety and efficiency of ETV and VPS in patients with obstructive hydrocephalus.
METHODS: In January 2019, a comprehensive search strategy of 3 electronic databases was initiated. A systematic search from database inception to December 30, 2018, on clinical outcome, safety, and efficiency of ETV and VPS in the treatment of obstructive hydrocephalus was conducted. The following electronic databases were searched: PubMed, Embase, and Cochrane Library for related randomized controlled trials (RCTs). Main outcomes included postoperative hematoma, postoperative infection, postoperative cerebrospinal fluid leakage, blockage rate, and mortality.
RESULTS: Of the 546 studies identified, 4 RCTs involving 250 patients met our inclusion criteria. The pooled results show that ETV was associated with lower incidence of postoperative infection (risk ratio [RR] 0.09, 95% confidence interval [CI]: 0.02-0.32, P = 0.0002); postoperative hematoma (RR 0.26, 95% CI: 0.08-0.88, P = 0.03); and blockage rate (RR 0.28, 95% CI: 0.13-0.60, P = 0.001) compared with VPS. Compared with VPS, ETV had no significant effect on incidence rate of postoperative cerebrospinal fluid leakage (RR 2.00, 95% CI: 0.30-13.16, P = 0.47) and mortality rates (RR 0.19, 95% CI: 0.03-1.09, P = 0.06), but there have been no deaths in patients treated with ETV.
CONCLUSIONS: On the basis of the meta-analysis of RCTs evaluating ETV and VPS, the incidence of complications and mortality was higher with the VPS procedure, and therefore greater benefits can be achieved using ETV.

Typical neuroimaging findings of posterior reversible encephalopathy syndrome include symmetrical white matter edema in subcortical white matter of bilateral occipital and parietal lobes, although variations do occur and more and more attention is being focused upon disease of infratentorial-isolated involved posterior reversible encephalopathy syndrome. In this article, we described 1 case of posterior reversible encephalopathy syndrome with isolated infratentorial brain involvement and reviewed the literature to identify an additional 36 cases in the PubMed database. We used various search terms, such as \"brainstem/cerebella/spinal posterior reversible encephalopathy syndrome,\" \"brainstem/cerebella/spinal reversible posterior leukoencephalopathy syndrome,\" \"brainstem/cerebella/spinal hypertensive encephalopathy,\" \"infratentorial posterior reversible encephalopathy syndrome,\" and \"posterior reversible encephalopathy syndrome variant.\" Then, we systematically analyzed the clinical and imaging characteristics of the 37 cases and found that posterior reversible encephalopathy syndrome with isolated involving infratentorial structures predominantly affect male patients compared with typical posterior reversible encephalopathy syndrome. The presence of extremely high blood pressure at onset is essential to the development of infratentorial-isolated involved posterior reversible encephalopathy syndrome. A relatively high rate of hydrocephalus and spinal cord involvement can be a distinctive feature of this kind of variant. Symptoms and outcomes are basically similar to typical posterior reversible encephalopathy syndrome.

BACKGROUND: Vertebrobasilar dolichoectasia (VBD) is a clinical entity associated with ischemic stroke, compression of cranial nerves or brainstem, and hydrocephalus. There have been relatively few studies following the progression of VBD in patients presenting with a variety of diverse clinical features.
METHODS: Here, we report a case study of a male with progressive VBD who was followed from November 2012 to December 2016. The patient had diagnosed hypertension for several years and suffered from left peripheral facial paralysis, recurrent ischemic attacks in the brainstem and cerebellum, obstructive hydrocephalus and frequent pneumonia. A series of cranial CT and multi-modal MRI scans were performed to explore the brain imaging features of the patient during follow-up.
CONCLUSIONS: The presented case study suggests that aging, uncontrolled hypertension, arterial dissection and infection may contribute to the exacerbation of VBD and recurrent ischemic stroke.

OBJECTIVE: To investigate the efficacy of endoscopic third ventriculostomy (ETV) for infantile hydrocephalus.
METHODS: Retrospectively reviewed the 17 infantile hydrocephalus cases who were treated with ETV between July 2009 and June 2013. The study includes 17 patients (4 Han and 13 Hui) between the ages of 51 and 337 days. Five cases with encephalitis history and 2 cases with cerebral hemorrhage, with the remaining 10 cases congenital hydrocephalus. ETVs were performed for all patients with 1 case failing because the severe ventricle inflammatory adhesion, excessive exudation, and vague basilar artery.
RESULTS: Among the 16 successful cases 7 cases improved remarkably : heads and ventricles reduced and cerebral cortexes thickening morphologically. The ventricles of the remaining cases were unchanged.
CONCLUSIONS: The ethnic minority account for the majority of the patients in this study. ETV is effective for infantile obstructive hydrocephalus.