Endoscopic Treatment of Temporal Arachnoid Cysts in 34 Patients

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• 作者：Tim Couvreur¹ ; ³ ; ^{Tim.Couvreur@UGent.be" class="auth_mail" title="E-mail the corresponding author} ; Giorgio Hallaert¹ ; Tatjana Van Der Heggen² ; Edward Baert¹ ; Frank Dewaele¹ ; Jean-Pierre Kalala Okito¹ ; Dimitri Vanhauwaert³ ; Marc Deruytter³ ; Dirk Van Roost¹ ; Jacques Caemaert¹
• 关键词：Cognition ; Epilepsy ; Headache ; Neurosurgery
• 刊名：World Neurosurgery
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：84
• 期：3
• 页码：734-740
• 全文大小：2072 K

文摘

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.

Materials and 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.

Conclusion

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.