Tratamiento neuroendoscopico de los quistes aracnoideos supratentoriales sintomáticos / Neuroendoscopy treatment of supratentorial arachnoid symptomatic cysts

ABSTRACT

Objective: Symptomatic supratentorial cysts are complicated lesion often associated with complex brain malformation and hydrocephalus. The traditional treatment was microsurgical technique or shunts. We present our experience of neuroendoscopic treatment of these lesions. Method: Between 1999 and 2007, 28 consecutive patients with symptomatic supratentorial cysts underwent neuroendoscopic treatment in our department. Results: The mean age was 3.1 years (range 1 month to 15 years), 18 were male and 10 female, In 5 patients a prenatal diagnosis was established. Eighteen patients presented increased intracranial pressure, 5 developmental delay, 3 seizures and 3 hemiparesis. According to its localization we have clasificated the cysts in interhemispheric (8), intraventricular (7), cuadrigerminal (5), paraventricular (5) and suprasellar (3). We have excluded the temporal cysts of this series. All patients underwent neuroendoscopic treatment involving cystoventriculostomy in 24 and cystocisternostomy in 4. The complications were 1 CFS leak, 3 patients required ventriculo-peritoneal shunt, 1 cystoperitoneal shunt and 1 subdural peritoneal shunt. There were no surgery-related morbidity or death. Conclusion: Endoscopic treatment of symptomatic supratentorial cysts can be considered a useful alternative to traditional treatment.