Clinical study of the surgical approaches for intracraalal arachnoid cysts

Abstract

Objective To investigate the surgical approaches for treatment of intracraniai arachnoid cysts. Methods The clinical data of 68 patients undergoing surgeries for intracranial arachnoid cyst were retrospectively analyzed. According to the surgical approaches adopted, these cases were classified into 4 groups, namely group A with surgical cyst removal (17 cases), group B with cyst-cistemal fenestration (25 cases), group C with cyst-peritoneal shunting (20 cases), and group D with stereotactic surgery (6 cases), and the outcomes of the patients were compared. Results Follow-up for more than 3 months showed an improvement of the symptoms in 86.8% of the patients, and CT scan showed cyst volume reduction in 75.0% of the patients. The postoperative complications included pneumocranium in 2 cases, intracranial hemorrhage in 3 cases, and incision infection in 2 cases. Radiographic improvement was achieved in 11/17 (64.7%) of the patients in group A, 21/25 (84.0%) in group B, 15/20 (75.0%) in group C, and 4/6 (66.7%) in group D; Symptomatic improvement occurred in 12/17 (70.6%) in group A, 22/25 (88.0%) in group B, 19/20 (95.0%) in group C, and 6/6 (100%) in group D. The patients in group A showed a high incidence of headache [7/17 (41.2%)]. Conclusion Surgical indications and surgical timing should be carefully evaluated in the treatment of intracranial arachnoid cysts. In terms of surgical safety and minimal invasiveness, cyst-peritoneal shunting should be the primary choice in most of the cases. Key words: Arachnoid cyst; Surgical treatment; Operational technique