Background: Controversy exists about the best treatment modality for arachnoid cysts. Widely accepted neurosurgical options include craniotomy with open resection of the cyst walls, shunting procedures and stereotactic fenestration of the cyst cavity. Recently, neuroendoscopic approach showed its effectiveness for treatment of these lesions.
Case description: In the presented case the large convexity arachnoid cyst was diagnosed in a 22-year-old woman with head dullness and local bone bulging. No neurologic signs were found. Surgery was performed by double-neuroendoscopic approach with simultaneous use of two flexible ventriculofiberscopes, which permitted wide resection of the inner cyst wall. Complete resolution of symptoms was noted soon after surgery.
Conclusion: Double-endoscopic approach might be useful for complex neuroendoscopic procedures that need different simultaneous surgical actions, particularly for cases of large arachnoid cysts.