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Simultaneous bone remodeling and surgical decompression of large Sylvian arachnoid cyst

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Abstract

The most common location for intracranial arachnoid cysts is the region of the Sylvian fissure, where they can be found in 49% of cases. Management of these cysts is still quite controversial. We present our surgical technique for the treatment of large Sylvian fissure arachnoid cysts which involves cyst decompression and simultaneous calvarial remodeling. After decreasing cyst size, remodeling of the frontal, temporal, and parietal bones follows. The cyst itself is treated with a cystoperitoneal shunt. In immediate postoperative period, correction of the deformity is observed. The cyst volume is reduced immediately after surgery, and adequate adaptation of the bone is achieved. Our surgical procedure for simultaneous bone remodeling and cyst decompression is a fast, simple, and effective treatment option for patients with large Sylvian fissure arachnoid cysts associated with significant cranial disfigurement. We consider cranial remodeling in case of large arachnoid cyst important not just because of the cosmetic result but also for reducing remaining intracranial space filled with cerebrospinal fluid. It may be an important factor to reduce the risk of intracystic and subdural hemorrhage. It is a widely applicable procedure that does not require special tools and expensive equipment, and yet it can help avoid multiple surgeries and complications tied to them.

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Authors and Affiliations

  1. Clinic of Neurosurgery, Clinical Center of Serbia, Dr Koste Todorovica 4, Belgrade, Serbia

    Bojana Zivkovic, Mirko Micovic, Vladimir Bascarevic, Andrija Savic & Lukas Rasulic

  2. Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia

    Mirko Micovic, Vladimir Bascarevic & Lukas Rasulic

Authors
  1. Bojana Zivkovic
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  2. Mirko Micovic
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  3. Vladimir Bascarevic
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  4. Andrija Savic
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  5. Lukas Rasulic
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Correspondence to Lukas Rasulic.

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The authors declare that they have no conflict of interest

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The manuscript has not been submitted to more than one journal for simultaneous consideration. The manuscript has not been published previously (partly or in full). One case was submitted just as an abstract on an international congress entitled “Cranial Remodeling Surgery in Patient with Large Arachnoid Cyst.” A single study is not split up into several parts to increase the quantity of submissions and submitted to various journals or to one journal over time. No data have been fabricated or manipulated (including images) to support the conclusions. No data, text, or theories by others are presented as if they were the authors’ own.

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Consent to submit has been received from all co-authors, as well as from the responsible authorities—tacitly or explicitly—at the institute/organization where the work has been carried out, before the work is submitted. All authors whose names appear on the submission have contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the results. Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from individual participants’ parent for whom identifying information (photos) is included in this article.

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Zivkovic, B., Micovic, M., Bascarevic, V. et al. Simultaneous bone remodeling and surgical decompression of large Sylvian arachnoid cyst. Neurosurg Rev 41, 683–688 (2018). https://doi.org/10.1007/s10143-018-0954-0

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  • DOI: https://doi.org/10.1007/s10143-018-0954-0

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