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 patients after surgery. Forty patients were improved after surgery while 4 patients remained symptomatic during the follow-up period.Conclusions: Cyst fenestration is the most effective treatment method for intracranial arachnoid cysts. It may be performed using either microscopic or endoscopic technique. Re-closure of the fenestration is the main problem especially when performed in young children.
AIM:To compare volumetric changes of intracranial arachnoid cysts (IACs) in different surgical techniques.
MATERIAL and METHODS:Sixty-six patients who underwent IAC surgery in our department between 2010 and 2020 were studied retrospectively. Based on the surgical technique, clinical and volumetric changes, postoperative complications, recurrence rates, and length of hospital stay were statistically compared.
RESULTS:Microsurgical fenestration (MF) was performed on 32 (48.5%) patients, endoscopic fenestration (EF) on 17 patients, cystoperitoneal shunt (CPS) on 11 patients, and EF + CPS in six patients. The mean IAC volume change rate was 68.54 mL, and the mean cyst volume change rate was 40.68%. The MF technique produces a significantly greater mean cyst volume change than the EF technique. The mean volume change in sylvian IAC is 4.8 times greater than in posterior fossa IAC, a significant difference. The mean cyst volume change is four times greater in patients with skull deformity than in patients with balance loss, and this difference is statistically significant. In patients with cranial deformity, the mean cyst volume change is 2.6 times greater than in patients with neurological dysfunction. This difference is also statistically significant. The volume of IAC decreased more in patients with postoperative complications, with a significant difference between the postoperative complication and the change in IAC volume.CONCLUSION: MF can achieve better volumetric reduction in IAC, particularly in patients with sylvian arachnoid cysts. However, more volumetric reduction increases the risk of postoperative complications.
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