Clinical study of the surgical approaches for intracranial arachnoid cysts

Abstract

Objective To investigate the surgical approaches indication, technique and efficacy for treatment of intracranial arachnoid cysts (IAC). Methods The clinical data of 56 patients with IAC who were diagnosed with MRI and/or CT techniques were retrospectively analyzed. According to the surgical approaches adopted, these cases were classified into 4 groups, group A with expectant treatment(12 cases), group B with endoscopic cystocisternal fenestration (15 cases), group C with cystoperitoneal shunting (21 cases), and group D with surgical cyst removal (8 cases). The outcomes of the patients were compared. Results The patients were followed up for 3 months to 46 months (mean 15 months). The rate of symptomatic improvement in group B was 14/15, in group C was 95.24% (20/21) and in group D was 5/8, and there was significant difference (χ2 =8.335, P <0.05). The rate of radiographic improvement in group B was 14/15, in group C was 90.48% (19/21) and in group D was 5/8, and there was significant difference (χ2 =8.235, P <0.05). The rate of complication in group B was 1/15, in group C was 14.29% (3/21), and in group D was 5/8, and there was significant difference (χ2 =8.256, P<0.05) Conclusions In terms of therapeutic effect, surgical safety and minimal invasiveness, cystoperitoneal shunting and endoscopic cystocisternal fenestration should be the primary choice. Key words: Arachnoid cysts; Surgical procedures, operative; Treatment outcome