Arachnoid cysts: diagnosis and treatment

Locatelli, Davide; Bonfanti, N; Sfogliarini, Roberto; Gajno, T. M.; Pezzotta, S.

doi:10.1007/bf00271139

Cited by 56 publications

(32 citation statements)

References 15 publications

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“…Although shunting may offer less serious complications than a procedure requiring fenestration [19,20], the cooperative European study o f 285 cases o f arachnoid cysts [21 ] showed that cyst shunting necessitated a second surgical procedure more frequently and that the number o f reoperations is more than twice as high in those with initially shunted cysts. Other series have documented a high rate o f shunt-related complications in patients with C P shunts [18,20]. Shunt revisions are inevitable, and other serious complications can occur [28], In our series o f patients.…”

Section: Discussionmentioning

confidence: 77%

“…Some authors feel early surgical inter vention is warranted even for asymptomatic cases due to the possibility o f damage to developing structures [16,18]. Children with untreated cysts may have slowly pro gressive damage to adjacent neural structures [4] or be at increased risk o f an associated subdural hematoma or intracystic hemorrhage following minor head trauma [13,27].…”

Section: Discussionmentioning

confidence: 99%

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Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Fewel

Levy

McComb³

1996

Pediatr Neurosurg

113

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Our review of 95 children with 102 intracranial arachnoid cysts treated surgically from 1976 to 1996 is presented. These patients are divided into two groups, those initially treated from 1976 to 1986 and those treated from 1987 to May 1996, to see whether any improvement in outcome had occurred. There were 31 patients (20 males/11 females) with 34 cysts treated from 1976 to 1986 and 64 patients (45 males/19 females) with 68 cysts treated from 1987 to 1996. The mean age at presentation for all cases was 4.9 years (range from 3 days to 17.8 years). The most common cyst location was the middle fossa. Treatment options for the management of intracranial arachnoid cysts include fenestration or shunting. We consider the avoidance of a shunt as a primary goal in the management of these patients. Accordingly, 82 (80%) of the cysts in our series were treated initially by fenestration. Fifty percent of those initially fenestrated from 1976 to 1986 required no further treatment as compared with 60% fenestrated from 1987 to 1996. The success rate of fenestration among those patients without associated hydrocephalus was significantly higher than in those with hydrocephalus; 73% without hydrocephalus required no additional treatment versus 32% with hydrocephalus. Seventeen percent of the patients treated from 1976 to 1986 required a subsequent ven-triculoperitoneal shunt as compared with 22% treated from 1987 to 1996. Twenty-nine percent of those patients initially fenestrated from 1976 to 1986 required a subsequent cystoperitoneal shunt as compared with only 12% treated from 1987 to 1996. Although not statistically significant, the second group of patients had a lower rate of reoperation, fewer complications, and a better clinical outcome than the first group. We recommend that in patients without evidence of hydrocephalus, cyst fenestration be considered as the primary procedure, as 73% of the patients in the two series remain shunt free. In those patients with hydrocephalus, we still recommend cyst fenestration, but with a ventriculoperitoneal shunt inserted before fenestration if the hydrocephalus is marked or after fenestration if the hydrocephalus is progressive.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Fewel

Levy

McComb³

1996

Pediatr Neurosurg

113

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“…Leptomeningeal cysts form when a traumatic brain injury leads to extensive tissue loss and the gathering of fluid in the subarachnoidal space; they are clearly distinguishable from developmental arachnoid cysts, since there is no blocking of drainage. This is important because leptomeningeal cysts are clearly not present during language development, while arachnoid cysts have been demonstrated by ultrasound to occur before birth (Hidalgo et al, 1982;Locatelli et al, 1987;Sandler et al, 1988), although expansion may occur postnatally (Okumura et al, 1995).…”

Section: Subjectsmentioning

confidence: 99%

Language Localization in Cases of Left Temporal Lobe Arachnoid Cyst: Evidence against Interhemispheric Reorganization

Stowe

Pruim

et al. 2000

Brain and Language

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“…The options are no intervention in asymp tomatic patients, simple aspiration, burr hole and fenes tration, placing a shunt, ventriculocystostomy, cranio tomy with wide excision of the membrane and establish ment of communication with the subarachnoid cisterns [6,11,14,22,34,43,45], Some advocate not operating on asymptomatic cyst [8,13,19,43], some operating on all patients [27], Once the decision to operate has been made, radiological evaluation is employed to aid in the treatment [3,9,10,13,19,27,46,52]. Among the various surgical options available the merits and demerits of shunting and craniotomy have been strongly debated [27,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Congenital Arachnoid Cysts in Children

Balsubramaniam

Laurent²,

Rouah³

et al. 1989

Pediatr Neurosurg

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Congenital arachnoid cysts (CAC) are benign developmental disorders. A number of theories have been proposed to explain the origin and progression to the symptomatic stage. Management strategies range from not treating the asymptomatic cysts to craniotomy, excision of cyst wall and establishment of a communication with the adjacent subarachnoid cistern or ventricle. Other lesions may resemble CAC, and can be differentiated from CAC only by a critical review of the biopsy specimen. We have reviewed our experience with true CAC and similar lesions. Based on our experience we recommend craniotomy, excision of cyst wall and establishment of a communication with an adjacent subarachnoid cistern or ventricle as the primary procedure.

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Arachnoid cysts: diagnosis and treatment

Cited by 56 publications

References 15 publications

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Language Localization in Cases of Left Temporal Lobe Arachnoid Cyst: Evidence against Interhemispheric Reorganization

Congenital Arachnoid Cysts in Children

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