Management of Arachnoid Cysts: A Comprehensive Review (original) (raw)
Related papers
Turkish Neurosurgery, 2012
AIm: Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. With advent of modern treatment techniques, debate continues regarding which surgical treatment is most effective. mATeRIAL and meTHods: A consecutive series of 75 patients with arachnoid cysts that were surgically treated between January 1992 and December 2009 are reported. Included in the study were 54 male and 21 female patients, ranging in age from 2 months to 45 years (mean age 20.02 years) at the time of surgery. Symptoms at presentation, location on the cysts, and treatment modalities were evaluated. ResuLTs: Headache was controlled in 92.5% of adult cases. Hydrocephalus, cognitive decline weakness and gait disturbances were controlled 100% after overall treatment methods. Follow-up CT scans showed significant reduction in cyst size in supratentorial arachnoid cysts. No significant changes in cyst size were found in infratentorial cysts but symptomatic improvements were noted. CoNCLusIoN: Patients with symptomatic arachnoid cysts regardless of age and cyst location should be treated. We think that avoiding shunt dependence should be one of the principle treatment goals. Proper patient selection results in good outcomes.
Different Surgical Options for the Management of Intracranial Arachnoid Cysts
2022
Background: The aims of this study are to present our results and determine the most effective method on the surgical treatment of intracranial arachnoid cysts.Methods: The data of 44 patients who underwent surgical treatment for intracranial arachnoid cyst between 2011 and 2019 were retrospectively reviewed. Age, gender, location of the cyst, clinical presentation, surgical technique and outcomes of patients were recorded and analyzed. The results were compared statistically. Results: Among the 44 patients, 36 were male and 8 were female with a mean age of 19.77 years. Twelve patients were children and 32 were adults. Signs of increased intracranial pressure were observed in 35 patients and epilepsy in 9 patients. The most frequent locations were temporal, frontotemporal and frontoparietal regions. Cyst fenestration was used in 34 patients while, cystoperitoneal shunt+fenestration in 8 and only shunt in 2 patients. Subdural effusion was seen in 5 patients and wound dehiscence in 6 ...
Intracranial arachnoid cysts: Clinical study with the findings of 32 surgically treated cases
Arachnoid cysts (ACs) are commonly encountered fluid collections in the central nervous system. Most cranial ACs are found incidentally and can be managed conservatively. This review presents and discusses clinical findings, diagnostic methods and management of intracranial ACs in 32 patients who were surgically treated in our clinic. The study included 23 male and nine female patients. Most of them were pediatric cases (77%) at the time of surgery. All diagnoses were confirmed on neuroradological examination. Twenty-six of the cysts were supratentorial (81.2%). The most common symptoms at presentation were seizures (50%), headache (37.5%), weakness (23%), and hydrocephalus (9%). Cystoperitoneal shunt placement, craniotomy, or endoscopic fenestration, are the surgical methods. Long-term outcome was favorable in most of these patients. Untreated, ACs may cause permanent severe neurological damage due to the progressive expansion of the cyst or hemorrhage. However, with surgical treatment most individuals with ACs do well.
Intracranial arachnoid cysts: Treatment alternatives and outcome in a series of 25 patients
Annals of Saudi medicine, 1997
A series of 25 patients with intracranial arachnoid cysts is analyzed retrospectively. There were 14 males and 11 females ranging in age between a few days and 58 (mean 10) years. Seventy-six percent of patients were children below the age of 15 years. Most of the patients presented with symptoms and signs of long-standing raised intracranial pressure, while localizing signs were rather uncommon. The clinical manifestations were often mild relative to the large size of the cyst. Associated hydrocephalus was present in three patients: one with suprasellar cyst and two with posterior fossa cysts. Seven patients with mild symptoms and small cysts were treated conservatively, while the remaining 18 patients underwent surgical treatment. The initial surgical procedure consisted of craniotomy and fenestration of the cyst in three patients, and cystoperitoneal shunting in the other 15. Of the three patients who underwent craniotomy, one improved postoperatively, while the remaining two dev...
Microsurgical Fenestration of Intracranial Symptomatic Arachnoid Cyst, Our Experience With 13 Cases
2018
Background: Arachnoid cysts are non-neoplastic, benign, intra-arachnoidal extra-axial lesions filled with fluid similar to or exactly the same as cerebrospinal fluid. They represent 1% of all intracranial space occupying lesions. Most arachnoid cysts are clinically silent. They present mainly in childhood. The common anatomical locations of arachnoid cysts are the middle cranial fossa, posterior fossa, suprasellar, quadrigeminal cistern, interhemispheric and convexity. Management of arachnoid cyst is a point of controversy. Objective: Evaluation of the microsurgical fenestration management option of arachnoid cysts regarding safety and outcome. Patients and Methods: This is retrospective study including 13 patients with symptomatic arachnoid cysts in different anatomical locations, in the time period between "January 2015 and September 2017". The study was conducted in the neurosurgery department of Assiut University Hospitals. Pre-operative patients' characteristics i...
Microsurgical Management of Symptomatic Intracranial Arachnoid Cyst: Experience of 15 Cases
Bangladesh Journal of Neurosurgery
Background: Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that covers the brain. In most of the cases these cysts are asymptomatic and do not require any treatment. Only symptomatic arachnoid cysts require treatment. Objectives: The objective of this study was to see the results of microsurgical treatment of intracranial arachnoid cyst. Methods: This retrospective cross sectional study was carried out in the Department of Neurosurgery, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh. Total 15 cases were included in this study for a period of 3 years. Data were collected including their operation procedures and follow up by questionnaires and finally observed the results. Results: Among the 15 patients about one third were presented in the second decades of life with male predominant. Significant clinical improvement was observed among most of the patients. The radiological decrease of the size of the cysts was also found. The results of...
Middle cranial fossa arachnoid cysts: not always a benign entity
British Journal of Radiology, 1998
Arachnoid cysts are often discovered as incidental findings on cranial imaging. A rare manifestation is described in a child presenting acutely with symptoms and signs of raised intracranial pressure. Arachnoid cysts are often discovered as inciden-the optic nerves with elevation of the optic papilla (Figure 2). tal findings on cranial imaging. However, they may occasionally become symptomatic because of their Emergency craniotomy was performed with fenestration of the arachnoid cyst into the interpedun-pressure effects on surrounding structures. Symptoms include headaches, seizures, mental cular cistern. The headache was much improved post-operatively but her visual acuity remained retardation, cognitive impairment and, rarely, focal neurological deficit [1, 2]. Associations with both poor. Cranial CT demonstrated a marked reduction in cyst size, re-expansion of a significant intracystic and subdural haemorrhages, due to rupture of bridging veins or vessels in the cyst proportion of the previously compressed brain, less ventricular compression and resolution of the wall are also well known [3]. We report a rare presentation of an arachnoid cyst as a rapidly midbrain distortion. expanding mass lesion with severe papilloedema.
Surgical Intervention in Sub-Arachnoid Cyst with Severe Neurological Manifestations
Madridge J Neurosci, 2018
This case looks at a 25 year old Chinese female with left cerebellar arachnoid cyst who has gone under sub-occipital craniotomy and marsupialisation of the cyst. The patient was clinically symptomatic, which prompted surgical intervention. Clinical assessments were done a day prior to surgery and subsequently on day 3 post-surgery. Our discussions are based upon the current literature review on conservative versus surgical management of a patient with arachnoid cyst. The discussion also further examines the clinical advantage of marsupialisation.