Surgical Treatment of Intracranial Arachnoid Cysts

ABSTRACT

Eighteen patients with symptomatic intracranial arachnoid cysts underwent 27 surgical procedures between January 1990 and December 1995. These were analysed with respect to their surgical procedures and results, complications and prognosis retrospectively, with an attempt assess the efficacy of each surgical procedure. Thirteen patients underwent excision of the inner and outer membranes with fenestration procedures to the basal cisterns(primary excision group), resulting in excellent or good outcomes in 12 cases, of which three patients were subjected to secondary shunt procedures due to symptom recurrence in two and persistence of the cyst in one during follow-up radiological study. There were no significant complications in this primary excision group. Four patients out of five in the primary shunt group had good or excellent results. But shunt revisions had to be performed in two patients;of these two patients, one died from subdural empyema and sepsis while the outcome of the other one was satisfactory. The results of this study suggested that excision and fenestration should be considered as the primary procedure in patients with symptomatic intracranial arachnoid cyst, especially in the pediatric age group.