Arachnoid cysts of the middle cranial fossa. Surgical management for headache.
To answer the question whether headache in association with a middle cranial fossa arachnoid cyst without other signs warrants surgery, an analysis of five cases is performed. Three of 5 patients became free of symptoms, compared with 15 of 19 (79%) patients that have been collected in the literature. Both failures were treated with a low pressure cysto-peritoneal shunt without fenestration. They complained of headache resembling postural headache after lumbar puncture. Surgical treatment in the form of a craniotomy with fenestration can be advised, but is major neurosurgery. Alternatively, the merit of a cysto-ventriculo-peritoneal shunt should be considered in this group of patients.
Voormolen
J H
JH
Department of Neurosurgery, University Hospital, Leiden, The Netherlands.
D000293:Adolescent; D000328:Adult; D016080:Arachnoid Cysts / Q000175:diagnosis / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011183:Postoperative Complications / Q000175:diagnosis