Outcome of Endoscopic Treatment of Intracranial Arachnoid Cysts
Objective: To analyze the outcome of endoscopic treatment of intracranial Arachnoid Cysts.
Materials and Methods: The study was conducted from July 2015 to September 2016 at the department of Neurosurgery Unit III, PGMI, Lahore General Hospital, Lahore. A total number of 13 patients were included in the study of both gender and age range of 05-45 years. Detailed history, neurological examination, preoperative CT and MRI scans were performed in all patients. Karl Storz (Lotta system) endoscope was used in all patients. Postoperative CT scan and follow up MRI scans were done in all patients.
Results: Out of 13 patients, there were 08 (60%) male and 05 (40%) female patients. Their age ranged from 05 - 45 years. The majority of patients in our study were in their second and third decade of life. In this study, the symptomatic relief and reduction in cyst size was gained in most of the patients with minimal recurrence and fewer number of side effects.
Conclusion: Endoscopic treatment 0f intracranial Arachnoid Cysts proved to be an effective and a very safe technique, provides the best results, avoids shunt dependency with minimal recurrence and fewer side effects.
2. Santamarta D, Aguas J, Ferrer E. The natural history of arachnoid cysts: endoscopic and cine view MRI evidence of slit-valve mechanism. Minim Invas Neurosurg. 1995; 38: 133-7.
3. Brackett CE, Rengachary SS. Arachnoid cysts. In: Youmans JR, ed. Neurological surgery, 2nd ed. Philadelphia: Saunders, 1982: 1436–1446.
4. Geissinger JD, Kohler WC, Robinson BW, Dawis FM. Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol. 1978; 10: 27-33.
5. Krawchenko J, Collins GH. Pathology of arachnoid cyst. Case report. J Neurosurg. 1979; 50: 224-8.
6. Harsh GR, Edwards MSB, Wilson CB. Intracranial Arachnoid Cysts in Children. J Neurosurg. 1986; 64: 835–842.
7. Rengachary SS, Watanabe I. Ultrastructure and Pathogenesis of Intracranial Arachnoid Cysts. J Neuropathol Exp Neurol. 1981; 40: 61–83.
8. Dei-Anang K, Voth D. Cerebral arachnoid cyst: A lesion of the child’s brain. J Neurosurg. Rev. 1989; 12: 59–62. 9. Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J. Arachnoid cysts of the sylvian fissure: Evidence of fluid secretion. J Neurosurg. 1984; 60: 803–813.
10. Oberbauer RW, Haase J, Pucher R: Arachnoid cysts in children: A European co-operative study. Childs Nerv Syst. 1992; 8: 281–286.
11. Kumagai M, Sakai N, Yamada H, Shinoda J, Nakashima T, Iwama T, Ando T. Postnatal development and enlargement of primary middle fossa arachnoid cyst recognized on repeat CT scans. Child’s Nerv Syst. 1986; 2: 211-5.
12. Hoffman HJ, Hendrick EB, Humphreys RP, Armstrong EA. Investigation and management of suprasellar arachnoid cysts. J Neurosurg. 1982; 57: 597-602.
13. Santamarta D, Aguas J, Ferrer E. The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit- valve mechanism. Minim Invas Neurosurg. 1995; 38: 133-7.
14. Galassi E, Piazza G, Gaist G, Frank F. Arachnoid cysts of middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol. 1980; 14: 211-9.
15. Becker T, Wagner M, Hofmann E, Warmuth- Metz M, Nadjimi M. Do arachnoid cysts grow? : A retrospective CT volumetric study: Neuroradiology, 1991; 33: 341-5.
16. Beltramello A, Mazza C. Spontanous disappearance of large middle cranial fossa arachnoid cyst. Surg Neurol. 1985; 24: 181-3.
17. Geissinged JD, Kohler WC, Robinson BW, Davis FM. Arachnoid cysts of middle cranial fossa: surgical considerations. Surg Neurol. 1978; 10: 27-33.
18. Auer LM, Holzer P, Ascher PW, Heppner F. Endoscopic neurosurgery. Acta Neurochir (wien). 1988; 90: 1–14.
19. Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R. Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wein). 1992; 119: 68–73.
20. Kim MH. The role of endoscopic fenestration procedures for cerebral arachnoid cysts. J Korean Med Sci. 1999; 14: 443–447.
21. Schroeder HW, Gaab MR, Niendorf WR. Neuroendoscopic approach to arachnoid cysts. J Neurosurg. 1996; 85: 293–298.
22. Spacca B, Kandasamy J, Mallucci CL, Genitori L. Endoscopic treatment of middle fossa arachnoid cyst: a series of 40 patients treated endoscopically in two centres. Childs Nerv Syst. 2009; 24.
23. Santamarta D, Aguas J, Ferrer E. The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg. 1995; 38: 133–137.
24. Caemaert J, Abdullah J, Callauw J. Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir. 1992; 119: 68-73.
25. Auer LM, Holzer P, Ascher PW. Endoscopic neurosurgery. Acta Neurochir. 1988; 90: 1-14.
Copyright (c) 2019 Pakistan Journal Of Neurological Surgery
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.