title: Endoscopic Treatment of Temporal Arachnoid Cysts in 34 Patients.
abstract: BACKGROUND
  Arachnoid cysts are lesions present in 1% of the population and usually found in the temporal fossa. Clinical and radiologic presentations can differ greatly. Despite intensive research, it is still debatable which patients will benefit from surgery.
  
  
  OBJECTIVE
  This study aims to investigate the pretreatment parameters influencing the outcome after neuroendoscopic treatment of temporal arachnoid cysts.
  
  
  METHODS
  A retrospective analysis of 34 patients who underwent an endoscopic fenestration of a temporal arachnoid cyst between July 1991 and December 2013 was performed.
  
  
  RESULTS
  In symptomatic patients, there was a clinical improvement in 76.4% of cases. The best results were found in treating symptoms related to intracranial hypertension, acute neurologic defects, and macrocrania. Patients with temporal lobe epilepsy improved after cyst fenestration in 33.3% of cases. Behavioral problems and psychomotor retardation remained largely unchanged. Patients with a complex neurologic presentation, often from a congenital syndrome and combined with an intellectual disability, had the least benefit from endoscopic surgery. Radiologic follow-up showed a cyst volume decrease in 91.2% of cases. Complications were present in 29.4%, but were mostly minor and transient.
  
  
  CONCLUSIONS
  This study demonstrates that patients with symptoms related to intracranial hypertension, acute neurologic deficits, and macrocrania have the best postoperative outcome. Also, patients with ipsilateral temporal lobe epilepsy seem to be good candidates for endoscopic arachnoid cyst fenestrations. In complex neurologic disorders without one of the previously mentioned symptoms, endoscopy remains less successful.
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium; Department of Neurosurgery, AZ Delta, Roeselare, Belgium. Electronic address: Tim.Couvreur@UGent.be.
authors.forename: Tim
authors.initials: T
authors.lastname: Couvreur
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Hallaert
authors.affiliation: Department of Paediatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Van Der Heggen
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Edward
authors.initials: E
authors.lastname: Baert
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Dewaele
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Kalala Okito
authors.affiliation: Department of Neurosurgery, AZ Delta, Roeselare, Belgium.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Vanhauwaert
authors.affiliation: Department of Neurosurgery, AZ Delta, Roeselare, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Deruytter
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Roost
authors.affiliation: Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Caemaert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016080:Arachnoid Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000209:etiology / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019586:Intracranial Hypertension / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognition; Epilepsy; Headache; Neurosurgery