Neurosurgical treatment of congenital arachnoids cysts in adults: 33 case series review

Abstract

Authors analyze a 33 case series of adult cases operated in Clinic Emergency Hospital "Bagdasar-Arseni", Bucharest, Fourth Neurosurgical Department, for intracranial arachnoids cysts between 1996 and 2006 and selected from 186 cases diagnosed with this type of disease. The series counts 11 woman (33.33%) and 22 man (66.66%), with a medium age of 37 years, and a total follow-up time of 5.6 years. The main symptoms were headache (28 - 84%), seizures (18-54.5%), dizziness (19-57.5%), behavioral abnormality and learning difficulty or memory troubles (17-51.5%). Papiledema was present in 8 cases (2424%). In 9 cases (27.27%) a cyst-peritoneal shunt was placed, and in the other 24 cases (72.72%) was performed an open craniotomy with cyst fenestration. In both procedures the opening CSF pressure was measured, ranging from 230 to 460 mm H20. 31 patients (93.9%) improved after surgery; one remained unchanged (3.03%) and one deteriorated (3.03%). Authors analyze the outcome and symptoms on medium term and conclude that in selected cases, both neurosurgical procedures improves the patients with low risks, decreases all symptoms, and specially the frequency of seizures under minimal anti epileptic therapy. The patient prognosis is directly related with the decrease in size of the cyst, this anatomic relation being and reliable argument for active neurosurgical management.