Surgical management strategies of intracranial arachnoid cysts: a single institution experience at 75 cases (original) (raw)
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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: 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...
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.
Surgical Neurology, 2006
We have previously presented an alternative method for surgical decompression of intracranial arachnoid cysts. This minimally invasive method, with insertion of an internal shunt from the cyst to the subdural compartment, seemed to be an efficient and simple, and hence promising technique. The aim of the present study was to investigate the long-term results of this procedure. This study is a questionnaire-based retrospective study that includes 31 adult patients (>18 years) who were operated on in our department for an arachnoid cyst in the temporal fossa or overlying the frontal convexity with the internal shunt technique between April 1990 and October 2003. Follow-up ranged from 15 months to 14.8 years (mean = 8.2 years). Of the patients, 83% were asymptomatic or had insignificant complaints at follow-up. A total of 17% reported no reduction of the preoperative complaints. No patient experienced worsening of the symptoms. The cyst was no longer visible on postoperative radiologic examinations in 37% of the patients. In 37%, the postoperative fluid volume was less than 50% of the original volume. In 13%, the cyst volume was reduced but the postoperative volume was greater than 50% of the original cyst volume. Thus, the cyst was unchanged in only 13% of the patients. There was no correlation between volume reduction and clinical improvement. A complication (subdural hygroma or hematoma) occurred in 7 patients, all with temporal cysts, leading to reoperation in 4. None of the complications caused permanent neurologic deficits or invalidity. Seven patients were reoperated on because of suspected or established treatment failure. The internal shunt technique is a relatively simple, safe, and efficient alternative method for treatment of arachnoid cysts. It should be considered a valuable alternative in the treatment of arachnoid cysts.
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...
Management of Arachnoid Cysts: A Comprehensive Review
Cureus
Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.
Cystoventricular Shunting of Intracranial Arachnoid Cysts
Pediatric Neurosurgery, 2003
Ten patients with intracranial arachnoid cysts were treated with direct shunting of the cyst to a lateral ventricle. The strategic goal of cystoventricular shunting is to establish physiologically normal intracranial pressure relationships, rather than cyst obliteration. Cystoventricular shunts were successful in treating single and multiple intracranial cysts in supratentorial and infratentorial locations and in patients with normal and enlarged lateral ventricles. Cystoventricular shunting is conceptually simple as well as effective and reliable.
Endoscopic Surgical Management of Intracranial Symptomatic Arachnoid Cyst A B S T R A C T
2018
Background and Aim: Intracranial Arachnoid Cysts (IAC) are suitable choices for endoscopic procedure to avoid craniotomy or shunt placement. Our main objective is to study the outcome of endoscopic procedure in IAC treatment. Methods and Materials/Patients: In this descriptive and retrospective study, we report our experience of 27 symptomatic patients with IAC who underwent endoscopic surgery at. The recorded data of patients' management including operations, outcomes, and follow up were studied retrospectively. The diagnosis was confirmed by neuroimaging, surgery and histopathological examination. Patients were postoperatively followed up on regular basis. Results: Size of the IAC decreased (significant to minimal) in all cases. Even where size reduction was minimal, patients' symptoms improved significantly. No IAC increased in size after endoscopic procedure. There was no recurrence of symptoms in the follow up period. There was no postoperative mortality or major morbidity related to the surgery. Conclusion: Based on our results, most of symptomatic IAC cases can be managed by endoscopic procedure which seems to be a safe and effective method. Citation: Hossain Chowdhury F, Raziul Haque M, Khaled Chowdhury N, Islam Khan Sh, Mohammod N. Endoscopic Surgical Management of Intracranial Symptomatic Arachnoid Cyst. Iran J Neurosurg. 2018; 4(2):61-74. http://dx.
Surgical Neurology International
Background: Intracranial arachnoid cysts (AC) are benign, cerebrospinal fluid filled spaces within the arachnoid layer of the meninges. Neurosurgical intervention in children and young adults has been extensively studied, but the optimal strategy in the elderly remains unclear. Therefore, we performed a single center retrospective study combined with a systematic review of the literature to compare cystoperitoneal (CP) shunting with other surgical approaches in the elderly cohort. Methods: Retrospective neurosurgical database search between January 2005 and December 2018, and systematic review of the literature using PRISMA guidelines were performed. Inclusion criteria: Age 60 years or older, radiological diagnosis of intracranial AC, neurosurgical intervention, and neuroradiological (NOG score)/clinical outcome (COG score). Data from both sources were pooled and statistically analyzed. Results: Our literature search yielded 12 studies (34 patients), which were pooled with our insti...