title: Clinical and radiological outcomes of surgical treatment for symptomatic arachnoid cysts in adults.
abstract: We retrospectively analyzed 63 patients (31 males and 32 females) with arachnoid cysts managed over a 15 year period at our institution. Surgical indications and modalities for the treatment of intracranial arachnoid cysts are controversial, although endoscopic fenestration is often recommended as a standard procedure. In our cohort, clinical postoperative results and radiological assessments based on the presenting symptoms, cyst location, cyst volume and surgical modalities were recorded. The most common symptoms included headaches (66.7%), dizziness (46%) and seizures (36.5%). Cyst wall excision with microsurgical craniotomy was carried out in 28 patients (44.4%), cyst fenestration in 16 (25.4%), cystoperitoneal or ventriculoperitoneal shunting in 15 (23.8%) and endoscopic fenestration in four patients (6.3%). A satisfactory clinical outcome was achieved in 51 patients (80.9%) and cyst reduction was achieved in 49 (77.8%), at the last follow-up. Clinical improvement correlated significantly with volume reduction in patients with suprasellar and infratentorial cysts (r=0.495; p=0.022) while a similar result was not found after surgery in patients with frontal and temporal cysts. Surgical complications were not correlated with surgical modalities, occurring in only seven patients (11.1%). The various surgical modalities did not influence outcomes. Patients with nonspecific symptoms such as headache may obtain favourable outcomes from surgical treatment with no severe complications, although, intracranial hypertension and neurological deficits are more definite surgical indications for arachnoid cysts.
authors.affiliation: Department of Neurosurgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 725 South WanPing Road, Shanghai, China. Electronic address: sunmoonciel@163.com.
authors.forename: Yongqian
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tongji Hospital, Shanghai Tongji University, Putuo District, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Changzheng Hospital Affiliated Shanghai Second Military University, Shanghai, China.
authors.forename: Mingkun
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 725 South WanPing Road, Shanghai, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016080:Arachnoid Cysts / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cyst fenestration; Cyst shunting; Intracranial arachnoid cyst; Microsurgical excision; Outcome; Surgical indications