Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management

Tamburrini, Gianpiero; Fabbro, Mateus Dal; Rocco, Concezio Di

doi:10.1007/s00381-008-0639-z

Cited by 26 publications

(44 citation statements)

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“…24 Other neurosurgeons advocate the placement of a fimbrial catheter through the fenestration into the adjacent ventricles or basal cisterns to prevent occlusion of the opening by collapse of the cyst and later scarring. 22,26 However, implanting such a prosthesis carries the long-term risks of an internal shunt such as displacement of the shunt or its occlusion. The author advises shrinking of the cyst wall if it is redundant, to avoid occlusion of the foramen of Monro or the sylvian aqueduct with recurrence of hydrocephalus.…”

Section: Failure and Recurrencementioning

confidence: 99%

Endoscopic treatment of quadrigeminal arachnoid cysts in children

El-Ghandour¹

2013

PED

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Object Quadrigeminal arachnoid cysts (QACs) are rare, comprising approximately 5%–10% of all intracranial arachnoid cysts. The management of these cysts is challenging, and their optimal surgical treatment is controversial. This study evaluates the role of endoscopy in the treatment of QACs in children, focusing on some factors or technical aspects that might influence the outcome. Methods Eighteen children with symptomatic QACs were the subject of this study. The group included 10 boys and 8 girls, with a mean age of 2.5 years. All patients had hydrocephalus. Surgical treatment included ventriculocystostomy (14 cases), endoscopic third ventriculostomy (14 cases), ventriculocystocisternostomy (2 cases), cystocisternostomy (2 cases), and removal of preexisting malfunctioning cystoperitoneal shunt (4 cases). Results Significant clinical improvement occurred in 15 cases (83.3%). Postoperative MRI showed a reduction in the cyst size in 14 cases (77.8%), whereas in the remaining 4 cases (22.2%) the cyst size was unchanged. A postoperative decrease in ventricular size was encountered in 16 cases (88.9%). Minor intraoperative bleeding occurred in 1 case (5.6%), which stopped spontaneously without any postoperative sequelae. Postoperative subdural hygroma occurred in 3 cases (16.7%) and required a subduroperitoneal shunt in 2 cases. During follow-up (mean 45.8 months), a repeat endoscopic procedure was performed in 7 patients (all 4 patients with a prior shunt and 3 patients without a prior shunt), and new shunt placement was required in 5 patients (all 4 patients with a prior shunt and 1 patient without a prior shunt). Thus, none of the patients with a prior shunt was able to become shunt independent, whereas 92.9% of patients without a prior shunt were able to avoid shunt placement. Conclusions Arachnoid cysts of the quadrigeminal cistern and the associated hydrocephalus can be effectively treated by endoscopy. The procedure is simple, minimally invasive, and associated with low morbidity and mortality rates. The fact that all patients who previously received shunts required a repeat endoscopic procedure and that none of these patients was able to become shunt independent makes it clear that endoscopic treatment should be considered the first choice in the management of patients with arachnoid cysts in the quadrigeminal cistern.

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Section: Failure and Recurrencementioning

confidence: 99%

Endoscopic treatment of quadrigeminal arachnoid cysts in children

El-Ghandour¹

2013

PED

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“…77,84,85 Because arachnoid cysts are common incidental findings, individuals frequently present with both an arachnoid cyst and an unrelated condition or symptom. Clinicians should exercise caution when ascribing any nonspecific symptom, such as headache, behavior disturbance, or epilepsy, to the presence of an arachnoid cyst.…”

Section: Arachnoid Cystsmentioning

confidence: 99%

“…Clinicians should exercise caution when ascribing any nonspecific symptom, such as headache, behavior disturbance, or epilepsy, to the presence of an arachnoid cyst. 85,86 Furthermore, such symptoms often persist after surgical treatment of an arachnoid cyst. 81,86 Although arachnoid cysts may occasionally enlarge or decrease in size, most do not change substantially over time.…”

Section: Arachnoid Cystsmentioning

confidence: 99%

Incidental Findings on Brain and Spine Imaging in Children

Maher¹,

Piatt²,

Ragheb³

et al. 2015

Pediatrics

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In recent years, the utilization of diagnostic imaging of the brain and spine in children has increased dramatically, leading to a corresponding increase in the detection of incidental findings of the central nervous system. Patients with unexpected findings on imaging are often referred for subspecialty evaluation. Even with rational use of diagnostic imaging and subspecialty consultation, the diagnostic process will always generate unexpected findings that must be explained and managed. Familiarity with the most common findings that are discovered incidentally on diagnostic imaging of the brain and spine will assist the pediatrician in providing counseling to families and in making recommendations in conjunction with a neurosurgeon, when needed, regarding additional treatments and prognosis.

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“…From a survey published in this journal [1] aimed at analyzing the neurosurgeon's attitude in case of symptomatic and asymptomatic temporal arachnoid cysts, it was apparent how the propension to operate increased when the symptoms and signs considered to be typical of these cysts were associated to the radiological image of a Galassi grade II temporal cyst (which was utilized to test the approach of several neurosurgeons from various international centers toward this type of lesion).…”

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confidence: 99%

“…In cases of asymptomatic subjects with incidental recognition of the malformation, most of the neurosurgeons who participated in the above-mentioned survey [1] were also in favor of a "prophylactic" operation which was motivated by the risk of intracranial bleeding due to a spontaneous or traumatic tearing of the cyst linings and their fragile vessels. Is such a risk so high to justify a preventive operation?…”

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confidence: 99%