Management of intrasellar arachnoidocele
DOI:
https://doi.org/10.36552/pjns.v27i4.930Keywords:
arachnoidocele, headache, neuroendoscopy, Turcic saddle, skull baseAbstract
Arachnoidocele in its sellar location is not common. The variability of its clinical signs and the lack of standard treatment make the management complex. The authors report a clinical case through which therapeutic modalities will be discussed. We report a case of a 42-year-old patient who complained of intermittent headaches of progressively increasing intensity over the past 2 years. The persistence of the headaches despite analgesic treatment had motivated the performance of a brain CT scan and then an MRI which had objectified the presence of an intrastellararachnoidocele. The endocrine laboratory function was normal. Short-term treatment with morphine and corticosteroids had achieved a rapid and long-lasting course after a 2-year follow-up. Endoscopic surgery is a treatment option for sellar arachnoidocele. The indication must take into account the clinical and radiological elements because some sellar arachnoidocele evolve favorably under drug treatment.
References
Wang X, Chen JX, You C, Jiang S. CT cisternography in intracranial symptomatic arachnoid cysts: Classification and treatment. J Neurol Sci. 2012 Jul 15;318(1-2):125-30. Epub 2012 Apr.
Murakami M, Okumura H, Kakita K. Recurrent intrasellar arachnoid cyst. Neurol Med Chir (Tokyo). 2003 Jun;43(6):312-5
Khelifi D, Debbabi W, Kharrat I, Samet S. Arachnoïdocèle intrasellaire primitive. Annales d'Endocrinologie. Sept 2020 ; 81(4):301 ; https://doi.org/10.1016/j.ando.2020.07.438
Mbaye M, Sylla N, Thioub M, Sy ECN, Faye M, Thiam AB, Ba MC, Badiane SB. Mise au point sur le kyste arachnoïdien intrasellaire: à propos d’un cas. Pan Afr Med J.2019 ;34 :55 DOI :10.11604/pamj.2019.34.55.18564
Smouni M, Failali HE, Bernichi O, Benkacem M. Arachnoïdocèle intrasellaire idiopathique : à propos d’un cas. Annales d’Endocrinologie. 2021;82(5):382-383 ; DOI: 10.1016/j.ando.2021.08.365
Dubuisson AS, Stevenaert A, Martin DH, Flandroy PP. Intrasellar arachnoid cysts. Neurosurgery. 2007 Sep;61(3):505-13; discussion 513
Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol. 1981 Jan;40(1):61-83
Schroeder HW, Gaab MR. Endoscopic observation of a slit-valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery. 1997 Jan;40(1):198-200
Nomura M, Tachibana O, Hasegawa M, Kohda Y, Nakada M, Yamashima T, Yamashita J, Suzuki M. contrast-enhanced MRI of intrasellar arachnoid cysts: relationship between the pituitary gland ant cyst. Neuroradiology. 1996 Aug;38(6):566-8
Tamburrini G, D'Angelo L, Paternoster G, Massimi L, Caldarelli M, Di Rocco C. Endoscopic management of intra and paraventricular CSF cysts. Childs Nerv Syst. 2007 Jun;23(6):645-51. Epub 2007
Weber F, Knopf H. Incidental findings in magnetic resonance imaging of the brains of healthy young men. J Neurol Sci. 2006 Jan 15;240(1-2):81-4. Epub 2005 Oct 26.
Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol. 2005 Jun;63(6):550-3; discussion 553
Dietemann JL, Guessoum M, Schultz A, Zöllner G, Sanoussi S, Maitrot D, Buchheit F. Kystes arachnoïdiens intrasellaires: scanographie et IRM, à propos de deux observations. J Neuroradiologie. 1997 ; 24 :168-73
Raffael C, McComb JG. To shunt or to fenestrate: Which is the best surgical treatment for arachnoid cysts in paediatric patients? Neurosurgery. 1988 Sep;23(3):338-42
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Diallo Moussa, André Jaques Valentin Tokpa, Youssouf Traoré, Koumaré Izoudine Blaise, Youssouf Sogoba, Sogoba Boubacar, Oumar Diallo, Kanikomo DrissaThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
