Abstract
A 65-year-old female was admitted because of progressive vertigo, truncal ataxia, and unsteadiness of gait for the past 6 years. Computed tomography (CT) and magnetic resonance imaging revealed a non-enhanced, large midline cyst in the posterior fossa and slightly dilated lateral and third ventricles. Metrizamide CT cisternography showed no communication between the cyst and the subarachnoid space. Suboccipital craniectomy, laminectomy of the atlas, and membranectomy of the cyst were performed. On light microscopic examination, the cyst wall was composed of arachnoid cells and connective tissues. Thus, this lesion was not an epithelial cyst but an arachnoid cyst occupying the fourth ventricle. An arachnoid cyst of the fourth ventricle is extremely rare, and only two cases were previously reported.
