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Child's Nervous System

, 25:1459 | Cite as

Treatment option for arachnoid cysts

  • Kyu-Won Shim
  • Yoon-Ho Lee
  • Eun-Kyung Park
  • Young-Seok Park
  • Joong-Uhn Choi
  • Dong-Seok Kim
Original Paper

Abstract

Objective

The objective of this study is to establish which treatment is the best operative intervention for arachnoid cyst.

Materials and methods

We reviewed a series of 209 cases with arachnoid cysts focusing on the effectiveness and safety. The cysts were treated with several surgical procedures including open surgery for fenestration, endoscopic fenestration, or cystoperitoneal shunting.

Results

Follow-up imaging studies showed that 176 out of 209 arachnoid cysts (84.2%) reduced in size during a mean postoperative follow-up period of 6.9 years (range, 1 to 14 years). Although a cystoperitoneal shunt was the best method for early achieving an obliteration of the sylvian cyst (89%), it had the danger of shunt dependency (42%) in addition to four early complications. Although endoscopic fenestration tended to be less effective in reducing the size of a sylvian cyst, it was safe and particularly effective in completely obliterating a suprasellar, quadrigeminal, and prepontine cyst.

Conclusion

Although the shunt for arachnoid cyst can get the more rapid good radiological outcome, the shunt-related complication and dependency would be hazardous. We suggest that endoscopic or reduced open procedures offer the advantage of avoiding a large craniotomy or the known complications of a cystoperitoneal shunt in treatment of arachnoid cysts. We could get the nearly same surgical outcome without shunt complications with endoscopic or open procedures.

Keywords

Arachnoid cyst Cystoperitoneal shunt Endoscopic procedure Shunt dependency Complication 

References

  1. 1.
    Aoki N, Sakai T (1990) Intraoperative subdural hematoma in a patient with arachnoid cyst in the middle cranial fossa. Childs Nerv Syst 6:44–46PubMedCrossRefGoogle Scholar
  2. 2.
    Aoki N, Sakai T, Umezawa Y (1990) Slit ventricle syndrome after cyst-peritoneal shunting for the treatment of intracranial arachnoid cyst. Childs Nerv Syst 6:41–43PubMedCrossRefGoogle Scholar
  3. 3.
    Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R (1992) Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wien) 119:68–73CrossRefGoogle Scholar
  4. 4.
    Charalampaki P, Filippi R, Welschehold S, Conrad J (2005) Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts). Minim Invasive Neurosurg 48:283–288PubMedCrossRefGoogle Scholar
  5. 5.
    Choi JU, Kim DS, Huh R (1999) Endoscopic approach to arachnoid cyst. Childs Nerv Syst 15:285–291PubMedCrossRefGoogle Scholar
  6. 6.
    Choux M, Raybaud C, Pinsard N, Hassoun J, Gambarelli D (1978) Intracranial supratentorial cysts in children excluding tumor and parasitic cysts. Childs Brain 4:15–32PubMedGoogle Scholar
  7. 7.
    Ciricillo SF, Cogen PH, Harsh GR, Edwards MS (1991) Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting. J Neurosurg 74:230–235PubMedCrossRefGoogle Scholar
  8. 8.
    Dei-Anang K, Voth D (1989) Cerebral arachnoid cyst: a lesion of the child’s brain. Neurosurg Rev 12:59–62PubMedCrossRefGoogle Scholar
  9. 9.
    Ersahin Y, Kesikci H, Ruksen M, Aydin C, Mutluer S (2008) Endoscopic treatment of suprasellar arachnoid cysts. Childs Nerv Syst 24:1013–1020PubMedCrossRefGoogle Scholar
  10. 10.
    Galassi E, Piazza G, Gaist G, Frank F (1980) Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol 14:211–219PubMedGoogle Scholar
  11. 11.
    Galassi E, Gaist G, Giuliani G, Pozzati E (1988) Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically. Acta Neurochir Suppl (Wien) 42:201–204Google Scholar
  12. 12.
    Gangemi M, Colella G, Magro F, Maiuri F (2007) Suprasellar arachnoid cysts: endoscopy versus microsurgical cyst excision and shunting. Br J Neurosurg 21:276–280PubMedCrossRefGoogle Scholar
  13. 13.
    Geissinger JD, Kohler WC, Robinson BW, Davis FM (1978) Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol 10:27–33PubMedGoogle Scholar
  14. 14.
    Hagebeuk EE, Kloet A, Grotenhuis JA, Peeters EA (2005) Bobble-head doll syndrome successfully treated with an endoscopic ventriculocystocisternostomy. Case report and review of the literature. J Neurosurg 103:253–259PubMedGoogle Scholar
  15. 15.
    Hanieh A, Simpson DA, North JB (1988) Arachnoid cysts: a critical review of 41 cases. Childs Nerv Syst 4:92–96PubMedGoogle Scholar
  16. 16.
    Harsh GR IV, Edwards MS, Wilson CB (1986) Intracranial arachnoid cysts in children. J Neurosurg 64:835–842PubMedCrossRefGoogle Scholar
  17. 17.
    Kim DS, Choi JU, Huh R, Yun PH, Kim DI (1999) Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus. Childs Nerv Syst 15:461–467PubMedCrossRefGoogle Scholar
  18. 18.
    LaCour F, Trevor R, Carey M (1978) Arachnoid cyst and associated subdural hematoma. Observations on conventional roentgenographic and computerized tomographic diagnosis. Arch Neurol 35:84–89PubMedGoogle Scholar
  19. 19.
    Okumura Y, Sakaki T, Hirabayashi H (1995) Middle cranial fossa arachnoid cyst developing in infancy. Case report. J Neurosurg 82:1075–1077PubMedCrossRefGoogle Scholar
  20. 20.
    Pei A, Zhang YZ, Zong XY, Wang XS, Song M (2007) Endoscopic treatment of suprasellar arachnoid cysts. Zhonghua Yi Xue Za Zhi 87:311–314PubMedGoogle Scholar
  21. 21.
    Rappaport ZH (1993) Suprasellar arachnoid cysts: options in operative management. Acta Neurochir (Wien) 122:71–75CrossRefGoogle Scholar
  22. 22.
    Santamarta D, Aguas J, Ferrer E (1995) The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg 38:133–137PubMedCrossRefGoogle Scholar
  23. 23.
    Schroeder HW, Gaab MR (1997) Endoscopic observation of a slit-valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery 40:198–200PubMedCrossRefGoogle Scholar
  24. 24.
    Schroeder HW, Gaab MR, Niendorf WR (1996) Neuroendoscopic approach to arachnoid cysts. J Neurosurg 85:293–298PubMedCrossRefGoogle Scholar
  25. 25.
    Sprung C, Mauersberger W (1979) Value of computed tomography for the diagnosis of arachnoid cysts and assessment of surgical treatment. Acta Neurochir Suppl (Wien) 28:619–626Google Scholar
  26. 26.
    Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8:647–650PubMedCrossRefGoogle Scholar
  27. 27.
    Tamburrini G, Dal Fabbro M, Di Rocco C (2008) Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst 24:593–604PubMedCrossRefGoogle Scholar
  28. 28.
    Wang JC, Heier L, Souweidane MM (2004) Advances in the endoscopic management of suprasellar arachnoid cysts in children. J Neurosurg 100:418–426PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Kyu-Won Shim
    • 1
  • Yoon-Ho Lee
    • 1
  • Eun-Kyung Park
    • 1
  • Young-Seok Park
    • 1
  • Joong-Uhn Choi
    • 2
  • Dong-Seok Kim
    • 1
  1. 1.Pediatric Neurosurgery, Severance Children’s Hospital, Brain Korea 21 Project for Medical Science, Department of Neurosurgery, Brain Research InstituteYonsei University College of MedicineSeoulSouth Korea
  2. 2.Pochon CHA University College of MedicineSeongnamSouth Korea

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