Surgical management of symptomatic suprasellar arachnoid cysts

ABSTRACT

The true incidence of intracranial arachnoid cysts is unknown because many may be asymptomatic throughout life. However, with the advent of CT and MRI the frequency of the diagnosis of arachnoid cyst has significantly increased. In adults they represent 9% of all the arachnoid cysts while in paediatric population this percentage reaches 15%.The various surgical options for treating suprasellar arachnoid cysts [SSAC] include craniotomy with fenestration or marsupialization of the cyst, cystoperitoneal shunt and percutaneous ventriculocysto-cisternostomy. Ten patients with SSAC were operated on in our institution since 1992. The aim of our work consists of describing the clinical manifestations, the radiological features and the different surgical methods to treat SSAC. The patients ranged in age from one month to 33 years [mean age = 8 yrs]. The signs and symptoms are referable to the size of the cyst. All patients with SSAC underwent preoperative CT, cisternography or MRI. In 7 patients, marsupialization of the cyst was performed; in 5 patients, a cystoperitoneal shunt was placed and ventricuhocysto-cisternostomy performed in only 2 patients. Five patients were operated more than one time undergoing two different methods of surgery