Neuroendoscopic surgery of intracranial cysts in adults.
OBJECTIVE
The purpose of this study was to describe the indications, surgical techniques and postoperative outcome of neuroendoscopic interventions in a heterogeneous group of intracranial cystic pathologies.


METHODS
Between 1992 and 2003, 127 patients with symptomatic intracranial cysts and cystic tumours underwent neuroendoscopic treatment in our department. In 22 patients indication for surgery was colloid cysts, in 9 patients pineal cysts and in 3 patients cavum vergae cysts. Twelve arachnoid cysts, 10 cystic craniopharyngiomas, 2 Rathke's cleft cysts and 69 malignant cystic tumours were operated on. The patients' mean age was 45 years and their clinical presentations varied from typical signs of increased intracranial pressure to focal neurological deficits.


RESULTS
One hundred and twenty-seven patients with intracerebral cystic space-occupying lesions were operated on using stereotactic frameless or frame-based endoscopic techniques. There was no operative mortality. The operative morbidity was 3.1% including 1 memory deficit due to fornix injury, 1 hemiparesis due to postoperative haematoma after lesion biopsy, 1 aseptic meningitis and 1 subdural fluid collection.


CONCLUSIONS
Endoscopic interventions enable neurosurgeons to manage intracranial cystic lesions. Via the same approach, the obstructed CSF pathways may be restored and consequently the increased intracranial pressure diminishes. With the aid of stereotactic guidance or a neuronavigation system, access to the lesion can be gained rapidly and with high accuracy.
Tirakotai
Wuttipong
W
Department of Neurosurgery, Philipps University, Baldingerstrasse, 35033 Marburg, Germany. tirakota@med.uni-marburg.de
Schulte
Dirk Michael
DM
Bauer
Bernhard L
BL
Bertalanffy
Helmut
H
Hellwig
Dieter
D
D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000145:classification / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003560:Cysts / Q000145:classification / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D038361:Neuronavigation; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D016896:Treatment Outcome