Investigation and management of suprasellar arachnoid cysts

Hoffman, Harold J.; Hendrick, E B; Humphreys, Robin P.; Armstrong, Edward A.

doi:10.3171/jns.1982.57.5.0597

Cited by 118 publications

(68 citation statements)

References 20 publications

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“…The arachnoid cysts become symptomatic during childhood in about 70–90% [3,4,5,6,7,8]. Besides the theory of a congenital origin of these pathologic findings, reports also support the hypothesis of acquiring these arachnoid cysts due to mechanisms such as infection, trauma, pressure or CSF flow changes [9,10,11].…”

Section: Introductionmentioning

confidence: 79%

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

Ariai¹,

Koerbel²,

Bornemann

et al. 2005

Pediatr Neurosurg

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Arachnoid cysts are collections of cerebrospinal fluid covered by arachnoidal cells and collagen. They may have a congenital or acquired origin. We present the case of a 7-year-old boy with a cerebellopontine angle arachnoid cyst harbouring a portion of neuroglia. Microscopically, the cyst wall consisted of a delicate fibrovascular membrane lined by a layer of arachnoidal cells. A thin layer of glial tissue ran the whole length of the cyst wall. This finding supports a congenital origin for this case. Cerebellopontine angle arachnoid cysts harbouring neuroglia without ependymal elements are very rare lesions and may be successfully treated by surgical resection.

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Section: Introductionmentioning

confidence: 79%

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

Ariai¹,

Koerbel²,

Bornemann

et al. 2005

Pediatr Neurosurg

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“…2,7 A similar percentage of patients with suprasellar cysts may show visual impairment. 2,6,21,24 In children, arachnoid cysts often produce mild neurological impairment relative to their large size, as seen in many of the patients in this series who had large sylvian cysts but no focal neurological deficits.…”

Section: Discussionmentioning

confidence: 95%

“…7,10 They are usually seen in cases of large supratentorial cysts, but may also be caused by smaller suprasellar or posterior fossa cysts associated with obstructive hydrocephalus. [21][22][23][24] Focal neurological deficits and epilepsy are present in less than 30% of patients with middle fossa arachnoid cysts. 2,7 A similar percentage of patients with suprasellar cysts may show visual impairment.…”

Section: Discussionmentioning

confidence: 99%

“…20 The clinical manifestations of arachnoid cysts are variable and often unspecific. 14,[21][22][23][24][25][26] The most common presenting symptoms and signs are those of raised intracranial pressure, craniomegaly, and developmental delay. 7,10 They are usually seen in cases of large supratentorial cysts, but may also be caused by smaller suprasellar or posterior fossa cysts associated with obstructive hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

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Intracranial Arachnoid Cysts: Treatment Alternatives and Outcome in A Series of 25 Patients

Jamjoom

1997

Ann Saudi Med

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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 developed complications consisting of wound infection and postoperative epilepsy in one and permanent severe neurological deficit in the other. In contrast, six of the 15 cysts treated by shunting resolved completely, eight were smaller, and one remained unchanged. Radiological regression of the cyst after shunting was associated with various degrees of clinical improvement in 13 patients (87%). Two (13%) of 15 shunted patients developed complications in the early postoperative period, consisting of wound infection in one and early shunt failure in the other. Three patients (20%) with shunts had late complications during the follow-up period, consisting of recurrent shunt failure in the first, subdural hematoma in the second, and perforation of the peritoneal catheter into the hepatic bile ducts in the third. These findings, as well as recent data from the literature, suggest that in the management of intracranial arachnoid cysts, cystoperitoneal shunting was more effective and had fewer serious complications than craniotomy and cyst fenestration, and therefore, it is recommended as the treatment of first choice. Ann Saudi Med 1997; 17(3) Arachnoid cysts are non-tumorous intra-arachnoid fluid collections that account for about 1% of all intracranial space-occupying lesions.1 They may develop thoughout the cerebrospinal axis, with a predominance in the sylvian region.2,3 Because of their benign nature and slow expansion, arachnoid cysts may remain symptomatic or produce only subtle symptoms and signs. On the other hand, they sometimes give rise to focal neurological deficits, raised intracranial pressure, and/or epileptic seizures. The question of when these lesions should be operated upon is, therefore, not always easy to answer. Moreover, the choice of the most appropriate surgical approach is still debated. 2,[4][5][6][7][8] In the following report, the author describes the clinical and radiological findings in 25 patients with intracranial arachnoid cysts. In addition, the treatment results are analyzed and compared with those publish...

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“…In this report we reviewed arachnoid cysts with a focus on the surgical management and selection criteria for management. All authors agree that symptoms of intracranial hypertension (with or without hydrocephalus), intractable seizures, and focal neurological deficits warrant treatment (1,4,6,7,12). Our selection criteria for management were age, symptomatic presentation, lesion location, and close communication with a ventricle or a cisternal compartment.…”

Section: Discussionmentioning

confidence: 99%

Surgical management strategies of intracranial arachnoid cysts: a single institution experience at 75 cases

Düz

Kaya²,

Daneyemez³

et al. 2012

Turkish Neurosurgery

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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. BuLGuLAR: Erişkin olguların %92,5'inde baş ağrısı kontrol altına alındı. Tüm tedavi şekilleri sonrasında hidrosefali, bilişsel bozulmalar ve yürüyüş bozuklukları %100 kontrol altına alındı. Takip tomografi görüntüleri supratentorial kistlerin boyutunda belirgin azalma gösterdi. İnfratentorial kistlerde belirgin küçülme saptanmasa da klinik olarak belirgin düzelme kaydedildi. soNuÇ: Semptomatik araknoid kisti olan olgular yaşına ve kist yerleşimine bakılmaksızın tedavi edilmelidirler. Şant bağımlılığını önlemek tedavinin prensiplerinden birisi olmalıdır. Doğru hasta seçimi tedavi yöntemlerinin başarısını artırmaktadır.

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Investigation and management of suprasellar arachnoid cysts

Cited by 118 publications

References 20 publications

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

Intracranial Arachnoid Cysts: Treatment Alternatives and Outcome in A Series of 25 Patients

Surgical management strategies of intracranial arachnoid cysts: a single institution experience at 75 cases

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