Different approaches to surgical treatment of arachnoid cysts. Wien Klin Wochenschr 118(Suppl 2):85-88

Department of Neurosurgery, Maribor Teaching Hospital, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
Wiener klinische Wochenschrift (Impact Factor: 0.84). 02/2006; 118 Suppl 2(S2):85-8. DOI: 10.1007/s00508-006-0540-2
Source: PubMed


Although most arachnoid cysts remain static fluid-filled compartments throughout life, some become enlarged, exerting a mass effect on adjacent neural structures. The decision-making process for patients with arachnoid cysts still represents a challenge for the neurosurgeon. We report three cases of intracranial arachnoid cysts treated with different surgical approaches: (i) endoscopic fenestration of the cyst into the lateral ventricle; (ii) a cystoperitoneal shunt; (iii) a cystoperitoneal shunt and establishment of communication between the cyst and the fourth ventricle with the help of an endoscope. Given the advances in instrumentation over the past decade, it is probable that most arachnoid cysts will be managed endoscopically in the future.

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    ABSTRACT: The posterior fossa may be enlarged due to: mega cisterna magna, arachnoid cyst or Dandy Walker malformation. These anomalies can be identified during routine ultrasound screening performed in the beginning of the second half of pregnancy (22nd week). The outcome of these findings is not clear. Therefore, it is difficult to advise the parents how to manage the pregnancy after the discovery of this anomaly. Most of the studies report a good prognosis in cases of mega cisterna magna or arachnoid cyst, as long as this finding is isolated. A Dandy-Walker malformation or non-isolated enlargement of the posterior fossa entail a guarded prognosis. Further studies are needed in order to enable better counseling.
    No preview · Article · Dec 2008 · Harefuah
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    ABSTRACT: We describe an 81-year old female patient who was seen at our outpatient clinic with a history of falls. The clinical diagnosis was concurrent with depressive symptoms, but an arachnoid cyst turned out to be the cause of her problems. The patient recovered completely after surgery.
    No preview · Article · May 2010 · International Psychogeriatrics
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    ABSTRACT: Introduction The surgical options for symptomatic arachnoid cysts are shunting, endoscopic fenestration, and craniotomy with fenestration. The endoscopic procedure has been found to be minimally invasive, safe, and effective. Results of endoscopic treatment of 21 patients of arachnoid cyst in vicinity to cistern or ventricle are described. Material and Methods All except one of the symptomatic arachnoid cysts with raised intracranial pressure were operated by endoscopic procedure. One patient of convexity cyst without any adjoining cistern/ventricle was excluded from study. Gaab 6-degree rigid telescope was used. Burr hole was made keeping in mind the straight trajectory between the cyst and cistern/ventricle. A minimum of 1 cm hole was made in all the cases. Third ventriculostomy was also done for associated hydrocephalus in quadrigeminal arachnoid cyst. Both the procedures could be done by single burr hole placed about 3–4 cm anterior to coronal suture. Results This is a prospective study of 21 arachnoid cysts. There were 6, 8, 5, and 2 cases of vermian, quadrigeminal region, sylvian fissure region, and cerebello-pontine region arachnoid cyst respectively. Symptomatic improvement occurred in 20 cases, while one infant with quadrigeminal arachnoid cyst required a ventriculo-peritoneal (VP) shunt. There was no mortality or any other complication except 3 cases of CSF leak, which stopped in 7 days time in two cases. Third ventriculostomy was done in the same sitting in 8 cases of quadrigeminal region arachnoid cyst. Follow-up ranged from 6 to 54 months. Conclusion Endoscopic treatment of arachnoid cyst with an adjoining cistern or ventricle is safe and effective. Third ventriculostomy can be done in the same sitting.
    No preview · Chapter · Dec 2012