Surgical indications for intracranial arachnoid cysts

Punzo, A; Conforti, Renata; Martiniello, D; Scuotto, A.; Bernini, F.P.; Cioffi, F. A.

doi:10.1055/s-2008-1052243

Cited by 10 publications

(9 citation statements)

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“…When craniotomy is performed to excise cysts, the complete removal of the cysts is difficult and the recurrence rate is approximately 25%. When cystoperitoneal shunting procedures are performed, there are many possible complications38). When endoscopic fenestrations are performed, it is difficult to control bleeding and copious amounts of irrigation are often required for a period of operations.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Neuroimaging Outcomes of Surgically Treated Intracranial Cysts in 110 Children

Lee

2012

J Korean Neurosurg Soc

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ObjectiveThe indications and optimal surgical treatments for intracranial cysts are controversial. In the present study, we describe long-term clinical and neuroimaging results of surgically treated intracranial cysts in children. The goal of this study is to contribute to the discussion of the debate.MethodsThis study included 110 pediatric patients that underwent surgeries to treat intracranial cysts. Endoscopic cyst fenestrations were performed in 71 cases, while craniotomies and cyst excisions (with or without fenestrations) were performed in 30 patients. Cystoperitoneal shunts were necessary for nine patients. Long-term results were retrospectively assessed with medical and neuroimaging records.ResultsClinical and radiological improvement was reported in 87.3% and 92.8% of cases, respectively, after endoscopic neurosurgery, and in 93.3% and 100% using open microsurgery whereas 88.9% and 85.7% after shunt operation. There were no statistical differences in clinical outcomes (p=0.710) or volume reductions (p=0.177) among the different surgeries. There were no mortalities or permanent morbidities, but complications such as shunt malfunctions, infections, and subdural hematomas were observed in 56% of the patients that had shunt operations. A total of 13 patients (11.8%) underwent additional surgeries due to recurrences or treatment failures. The type of surgery performed did not influence the recurrence rate (p=0.662) or the failure rate (p=0.247).ConclusionEndoscopic neurosurgeries are less invasive than microsurgeries and are at least as effective as open surgeries. Thus, given the advantages and complications of these surgical techniques, we suggest that endoscopic fenestration should be the first treatment attempted in children with intracranial cysts.

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Section: Introductionmentioning

confidence: 99%

Clinical and Neuroimaging Outcomes of Surgically Treated Intracranial Cysts in 110 Children

Lee

2012

J Korean Neurosurg Soc

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“…Most authors contribute the fact that arachnoid cysts become symptomatic later in life to cyst growth resulting in a compression, displacement and irritation of the surrounding structures [2, 4, 5, 7, 12]. However, even after operation, the effective mechanism of cyst growth remains unclear in many cases, and different theories are advanced: ball valve mechanisms [13, 14], active fluid secretion from the cyst wall [9, 15]or osmotic gradients following minor hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Ectopic Choroid Plexus within a Juvenile Arachnoid Cyst of the Cerebellopontine Angle: Cause of Cyst Formation or Reason of Cyst Growth

Schuhmann¹,

Tatagiba²,

Hader³

et al. 2000

Pediatr Neurosurg

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“…Communicating arachnoid cysts especially in asymptomatic cases do not require any surgical treatment, but clinical follow up by serial computed tomography (CT) is sufficient. 6,8,12) Each of these techniques has its proponents and debate continues regarding which surgical treatment is the most effective. 2,3,8,9) However, these treatments are sometimes associated with postoperative complications such as subdural effusion, shunt dysfunction, and shunt infection.…”

Section: Introductionmentioning

confidence: 99%

“…6,8,12) Each of these techniques has its proponents and debate continues regarding which surgical treatment is the most effective. 2,3,8,9) However, these treatments are sometimes associated with postoperative complications such as subdural effusion, shunt dysfunction, and shunt infection. 5,7,8,11,12) We report a pediatric case of arachnoid cyst in the left middle cranial fossa without subdural hematoma, which later showed subdural effusion with slight midline shift.…”

Section: Introductionmentioning

confidence: 99%

“…2,3,8,9) However, these treatments are sometimes associated with postoperative complications such as subdural effusion, shunt dysfunction, and shunt infection. 5,7,8,11,12) We report a pediatric case of arachnoid cyst in the left middle cranial fossa without subdural hematoma, which later showed subdural effusion with slight midline shift. We closed the outer wall of the arachnoid cyst by arachnoidplasty using Dexon mesh and fibrin glue to maintain the physiological pathway of cerebrospinal fluid (CSF) without shunting, resulting in resolution of the subdural hygroma.…”

Section: Introductionmentioning

confidence: 99%

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Arachnoidplasty for Traumatic Subdural Hygroma Associated With Arachnoid Cyst in the Middle Fossa -Case Report-

Hasegawa

Tanaka

Kato

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 5-year old boy presented with an arachnoid cyst in the middle cranial fossa with mild midline shift manifesting as headache and loss of activity. Computed tomography (CT) showed subdural hygroma. Burr-hole drainage was carried out and symptoms were improved postoperatively. However, recollection of subdural hygroma was found on follow-up CT 3 weeks after subdural drainage. He underwent craniotomy, and tearing of the outer wall of the arachnoid cyst was observed. The ruptured cyst wall was tightly closed by arachnoidplasty to prevent cerebrospinal fluid leakage. Arachnoidplasty was effective for traumatic subdural hygroma with arachnoid cyst for reconstruction.

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Surgical indications for intracranial arachnoid cysts

Cited by 10 publications

References 0 publications

Clinical and Neuroimaging Outcomes of Surgically Treated Intracranial Cysts in 110 Children

Clinical and Neuroimaging Outcomes of Surgically Treated Intracranial Cysts in 110 Children

Ectopic Choroid Plexus within a Juvenile Arachnoid Cyst of the Cerebellopontine Angle: Cause of Cyst Formation or Reason of Cyst Growth

Arachnoidplasty for Traumatic Subdural Hygroma Associated With Arachnoid Cyst in the Middle Fossa -Case Report-

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