title: Treatment option for arachnoid cysts.
abstract: OBJECTIVE
  The objective of this study is to establish which treatment is the best operative intervention for arachnoid cyst.
  
  
  METHODS
  We reviewed a series of 209 cases with arachnoid cysts focusing on the effectiveness and safety. The cysts were treated with several surgical procedures including open surgery for fenestration, endoscopic fenestration, or cystoperitoneal shunting.
  
  
  RESULTS
  Follow-up imaging studies showed that 176 out of 209 arachnoid cysts (84.2%) reduced in size during a mean postoperative follow-up period of 6.9 years (range, 1 to 14 years). Although a cystoperitoneal shunt was the best method for early achieving an obliteration of the sylvian cyst (89%), it had the danger of shunt dependency (42%) in addition to four early complications. Although endoscopic fenestration tended to be less effective in reducing the size of a sylvian cyst, it was safe and particularly effective in completely obliterating a suprasellar, quadrigeminal, and prepontine cyst.
  
  
  CONCLUSIONS
  Although the shunt for arachnoid cyst can get the more rapid good radiological outcome, the shunt-related complication and dependency would be hazardous. We suggest that endoscopic or reduced open procedures offer the advantage of avoiding a large craniotomy or the known complications of a cystoperitoneal shunt in treatment of arachnoid cysts. We could get the nearly same surgical outcome without shunt complications with endoscopic or open procedures.
authors.affiliation: Pediatric Neurosurgery, Severance Children's Hospital, Brain Korea 21 Project for Medical Science, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Shim
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Park
authors.forename: Young-Seok
authors.initials: YS
authors.lastname: Park
authors.forename: Joong-Uhn
authors.initials: JU
authors.lastname: Choi
authors.forename: Dong-Seok
authors.initials: DS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016080:Arachnoid Cysts / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications; D017410:Practice Guidelines as Topic; D012449:Safety; D016896:Treatment Outcome; D055815:Young Adult