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Volume 4, Issue 2 (Spring 2018)
Iran J Neurosurg 2018, 4(2): 61-74 |
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Chowdhury F H, Haque M R, Khaled Chowdhury N, Khan S I, Mohammod N. Endoscopic Surgical Management of Intracranial Symptomatic Arachnoid Cyst . Iran J Neurosurg 2018; 4 (2) :61-74
URL: http://irjns.org/article-1-107-en.html
URL: http://irjns.org/article-1-107-en.html
Forhad Hossain Chowdhury * 
1, Mohammod Raziul Haque2 , Noman Khaled Chowdhury3 , Shamsul Islam Khan4 , Noor Mohammod5
1, Mohammod Raziul Haque2 , Noman Khaled Chowdhury3 , Shamsul Islam Khan4 , Noor Mohammod5
1- Neurosurgery, National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh , forhadchowdhury74@yahoo.com
2- Department of Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
3- Neurosurgery, National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh
4- Neurosurgery, National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
5- Department of Radiology, Comilla Medical College, Comilla, Bangladesh Dhaka, Bangladesh.
2- Department of Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
3- Neurosurgery, National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh
4- Neurosurgery, National Institute of Neurosciences and Hospital, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
5- Department of Radiology, Comilla Medical College, Comilla, Bangladesh Dhaka, Bangladesh.
Abstract: (5903 Views)
Background and Aim: Intracranial Arachnoid Cysts (IAC) are suitable choices for endoscopic procedure to avoid craniotomy or shunt placement. Our main objective is to study the outcome of endoscopic procedure in IAC treatment.
Methods and Materials/Patients: In this descriptive and retrospective study, we report our experience of 27 symptomatic patients with IAC who underwent endoscopic surgery at National Institute of Neurosciences Hospital and Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2009 to December 2016. The recorded data of patients’ management including operations, outcomes, and follow up were studied retrospectively. The diagnosis was confirmed by neuroimaging, surgery and histopathological examination. Patients were postoperatively followed up on regular basis.
Results: Size of the IAC decreased (significant to minimal) in all cases. Even where size reduction was minimal, patients’ symptoms improved significantly. No IAC increased in size after endoscopic procedure. There was no recurrence of symptoms in the follow up period. There was no postoperative mortality or major morbidity related to the surgery.
Conclusion: Based on our results, most of symptomatic IAC cases can be managed by endoscopic procedure which seems to be a safe and effective method.
Methods and Materials/Patients: In this descriptive and retrospective study, we report our experience of 27 symptomatic patients with IAC who underwent endoscopic surgery at National Institute of Neurosciences Hospital and Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2009 to December 2016. The recorded data of patients’ management including operations, outcomes, and follow up were studied retrospectively. The diagnosis was confirmed by neuroimaging, surgery and histopathological examination. Patients were postoperatively followed up on regular basis.
Results: Size of the IAC decreased (significant to minimal) in all cases. Even where size reduction was minimal, patients’ symptoms improved significantly. No IAC increased in size after endoscopic procedure. There was no recurrence of symptoms in the follow up period. There was no postoperative mortality or major morbidity related to the surgery.
Conclusion: Based on our results, most of symptomatic IAC cases can be managed by endoscopic procedure which seems to be a safe and effective method.
Keywords: Intracranial, Symptomatic, Arachnoid cyst, Endoscopic surgical management, Cysto-ventriculostomy, Cysto-cisternostomy, Endoscopy
Type of Study: Research |
Subject:
Basic Neurosurgery
References
1. Epelman M, Daneman A, Blaser SI, Ortiz-Neira C, Konen O, Jarrín J, et al. Differential diagnosis of intracranial cystic lesions at head US: Correlation with CT and MR imaging. Radiographics. 2006; 26(1):173-96 [DOI:10.1148/rg.261055033] [PMID] [DOI:10.1148/rg.261055033]
2. Rengachary SS. Intracranial arachnoid and ependymal cysts. In: Wilkins RH, Rengachary SS, editors. Neurosurgery. New York: McGraw-Hill; 1985.
3. Raju S, Sharma RS, Moningi S, Momin J. Neuroendoscopy for intracranial arachnoid cysts in infants: Therapeutic considerations. Journal of Neurological Surgery 2016; 77(04): 333-43. [PMID] [PMID]
4. Wang C, Han G, You C, Liu C, Wang J, Xiong Y. Individual surgical treatment of intracranial arachnoid cyst in pediatric patients. Neurology India. 2013; 61(4):400-5. [DOI:10.4103/0028-3886.117618] [PMID] [DOI:10.4103/0028-3886.117618]
5. Rappaport ZH. Suprasellar arachnoid cysts: Options in operative management. Acta Neurochirurgica. 1993; 122(1-2):71-5. [DOI:10.1007/BF01446989] [DOI:10.1007/BF01446989]
6. Al Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. Journal of Neurosurgery: Pediatrics. 2010; 5(6):578-85. [DOI:10.3171/2010.2.PEDS09464] [DOI:10.3171/2010.2.PEDS09464]
7. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. Journal of Neurosurgery. 2013; 118(2):222-31. [DOI:10.3171/2012.10.JNS12548] [PMID] [DOI:10.3171/2012.10.JNS12548]
8. Sharma M, Mittal RS, Bansal R, Sharma A. Intracranial arachnoid cyst: An institutional experience. Romanian Neurosurgery. 2016; 30(1):136-42. [DOI:10.1515/romneu-2016-0023]
9. Rengachary SS, Kennedy JD. Intracranial arachnoid cysts and ependymal cysts. In: Wilkins RH, Rengachary SS, editors. Neurosurgery. New York: McGraw-Hill; 1996. [PMID]
10. Nicholas M, Marion L. Arachnoid cysts. In: Winn HR, editor. Youmans Neurological Surgery. Philadelphia: Saunders; 2011.
11. Diakoumakis EE, Weinberg B, Mollin J. Prenatal sonographic diagnosis of a suprasellar arachnoid cyst. Journal of Ultrasound in Medicine. 1986; 5(9):529-30. [DOI:10.7863/jum.1986.5.9.529] [PMID] [DOI:10.7863/jum.1986.5.9.529]
12. Oberbauer RW, Haase J, Pucher R. Arachnoid cysts in children: A European co-operative study. Child's Nervous System. 1992; 8(5):281-86. [DOI:10.1007/BF00300797] [PMID] [DOI:10.1007/BF00300797]
13. Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R. Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochirurgica. 1992; 119(1-4):68-73. [DOI:10.1007/BF01541784] [DOI:10.1007/BF01541784]
14. Galassi E, Piazza G, Gaist G, Frank F. Arachnoid cysts of the middle cranial fossa: A clinical and radiological study of 25 cases treated surgically. Surgical Neurology. 1980; 14(3):211-19. [PMID] [PMID]
15. Raffel C, McComb JG. To shunt or to fenestrate: Which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery. 1988; 23(3):338-42. [DOI:10.1227/00006123-198809000-00009] [PMID] [DOI:10.1227/00006123-198809000-00009]
16. Schroeder HW, Gaab MR. Endoscopic observation of a slit-valve mechanism in a suprasellarprepontine arachnoid cyst: Case report. Neurosurgery. 1997; 40(1):198-200. [DOI:10.1097/00006123-199701000-00045] [PMID] [DOI:10.1097/00006123-199701000-00045]
17. Duz B, Kaya S, Daneyemez M. Surgical management strategies of intracranial arachnoid cysts: A single institution experience of 75 cases. Turkish Neurosurgery. 2012; 22(5):591-8. [DOI:10.5137/1019-5149.JTN.5616-11.0] [DOI:10.5137/1019-5149.JTN.5616-11.0]
18. Lee JY, Kim JW, Phi JH, Kim SK, Cho BK, Wang KC. Enlarging arachnoid cyst: A false alarm in infants. Child's Nervous System. 28(8):1203-11. [DOI: 10.1007/s00381-012-1722-z] [PMID] [DOI:10.1007/s00381-012-1722-z]
19. Hellwig D, Schulte M, Tirakotai W. Surgical management of arachnoid, suprasellar, and Rathke's cleft cysts. In: Schmidek HH, Roberts DW, editors. Schmidek and Sweet Operative Neurosurgical Techniques. Vol 1. Philadelphia: Saunders; 2006. [PMID]
20. Gelabert-González M, Serramito-García R, García-Allut A. [Spontaneous resolution of an asymptomatic intracranial arachnoid cysts (Spanish)]. Neurocirugia. 2008; 19(4):361-4. [PMID] [DOI:10.1016/S1130-1473(08)70224-0]
21. Gangemi M, Colella G, Magro F. Suprasellar arachnoid cysts: Endoscopy versus microsurgical cyst excision and shunting. British Journal of Neurosurgery. 2007; 21(3):276-80. [DOI:10.1080/02688690701339197] [PMID] [DOI:10.1080/02688690701339197]
22. Gangemi M, Seneca V, Colella G, Cioffi V, Imperato A, Maiuri F. Endoscopy versus microsurgical cysts excision and shunting for treating intracranial arachnoid cysts. Journal of Neurosurgery: Pediatrics. 2011; 8(2):158-64. [DOI:10.3171/2011.5.PEDS1152] [DOI:10.3171/2011.5.PEDS1152]
23. Gallentine WB, Mikati MA. Intraoperative electrocorticography and cortical stimulation in children. Journal of Clinical Neurophysiology. 2009; 26(2):95-108. [DOI:10.1097/WNP.0b013e3181a0339d] [PMID] [DOI:10.1097/WNP.0b013e3181a0339d]
24. Gui SB, Wang XS, Zong XY, Li CZ, Li B, Zhang YZ. Assessment of endoscopic treatment for middle cranial fossa arachnoid cysts. Child's Nervous System. 2011; 27(7):1121-28. [DOI:10.1007/s00381-011-1399-8] [PMID] [DOI:10.1007/s00381-011-1399-8]
25. Oertel JM, Wagner W, Mondorf Y, Baldauf J, Schroeder HW, Gaab MR. Endoscopic treatment of arachnoid cysts: A detailed account of surgical techniques and results. Neurosurgery. 2010; 67(3):824-36. [DOI:10.1227/01.NEU.0000377852.75544.E4] [PMID] [DOI:10.1227/01.NEU.0000377852.75544.E4]
26. Yadav YR, Parihar V, Sinha M, Jain N. Endoscopic treatment of the suprasellar arachnoid cyst. Neurology India. 2010; 58(2):280-83. [DOI:10.4103/0028-3886.63772] [PMID] [DOI:10.4103/0028-3886.63772]
27. Kandasamy J, Souweidane M. Editorial: Arachnoid cysts. Journal of Neurosurgery: Pediatrics. 2012; 9(3):22830 [DOI:10.3171/2011.11.PEDS11411] [PMID] [DOI:10.3171/2011.11.PEDS11411]
28. Helland CA, Wester K. A population-based study of intracranial arachnoid cysts: Clinical and neuroimaging outcomes following surgical cyst decompression in children. Journal of Neurosurgery. 2006; 105(5 Suppl):385-90. [PMID] [PMID]
29. Koch CA, Moore JL, Voth D. Arachnoid cysts: How do postsurgical cyst size and seizure outcome correlate? Neurosurgical Reviews. 1998; 21(1):14-22. [DOI:10.1007/BF01111480] [PMID] [DOI:10.1007/BF01111480]
30. Karabagli H, Etus V. Success of pure neuroendoscopic technique in the treatment of Sylvian arachnoid cysts in children. Child's Nervous System. 2012; 28(3):445-52. [DOI:10.1007/s00381-011-1632-5] [PMID] [DOI:10.1007/s00381-011-1632-5]
31. Levy ML, Wang M, Aryan HE, Yoo K, Meltzer H. Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration. Neurosurgery. 2003; 53(5):1138-44. [DOI:10.1227/01.NEU.0000089060.65702.03] [PMID] [DOI:10.1227/01.NEU.0000089060.65702.03]
32. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, et al. Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Child's Nervous System. 2000; 16(2):111–6. [DOI:10.1007/s003810050024] [PMID] [DOI:10.1007/s003810050024]
33. Marin-Sanabria EA, Yamamoto H, Nagashima T, Kohmura E. Evaluation of the management of arachnoid cyst of the posterior fossa in pediatric population: Experience over 27 years. Child's Nervous System. 2007; 23(5):535-42. [DOI:10.1007/s00381-006-0284-3] [PMID] [DOI:10.1007/s00381-006-0284-3]
34. Martínez-Lage JF, Ruíz-Espejo AM, Almagro MJ, Alfaro R, Felipe-Murcia M, López-Guerrero AL. CSF overdrainage in shunted intracranial arachnoid cysts: A series and review. Child's Nervous System. 2009; 25(9):1061-9. [DOI:10.1007/s00381-009-0910-y] [PMID] [DOI:10.1007/s00381-009-0910-y]
35. Boutarbouch M, El Ouahabi A, Rifi L, Arkha Y, Derraz S, El Khamlichi A. Management of intracranial arachnoid cysts: Institutional experience with initial 32 cases and review of the literature. Clinical Neurology and Neurosurgery. 2008; 110(1):1-7. [DOI:10.1016/j.clineuro.2007.08.009] [PMID] [DOI:10.1016/j.clineuro.2007.08.009]
36. Shim KW, Lee YH, Park EK, Park YS, Choi JU, Kim DS. Treatment option for arachnoid cysts. Child's Nervous System. 2009; 25(11):1459-66. [DOI:10.1007/s00381-009-0930-7] [PMID] [DOI:10.1007/s00381-009-0930-7]
37. Bilginer B, Onal MB, Oguz KK, Akalan N. Arachnoidcyst associated with subdural hematoma: Report of three cases and review of the literature. Child's Nervous System. 2009; 25:119-24. [DOI:10.1007/s00381-008-0728-z] [PMID] [DOI:10.1007/s00381-008-0728-z]
38. Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: Neuroradiological evidence and surgical treatment. Journal of Neurosurgery. 2009; 110(6):1250-55. [DOI:10.3171/2008.4.17509] [PMID] [DOI:10.3171/2008.4.17509]
39. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: Analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery. 1997; 40(3):483–90. [DOI:10.1227/00006123-199703000-00010] [DOI:10.1227/00006123-199703000-00010]
40. Spacca B, Kandasamy J, Mallucci CL, Genitori L. Endoscopic treatment of middle fossa arachnoid cysts: A series of 40 patients treated endoscopically in two centres. Child's Nervous System. 2010; 26(2):163-72. [DOI:10.1007/s00381-009-0952-1] [PMID] [DOI:10.1007/s00381-009-0952-1]
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