Helland Christian A, Wester Knut
Section for Neurosurgery, Department of Surgical Sciences, University of Bergen, and Haukeland University Hospital, Bergen, Norway.
J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1129-35. doi: 10.1136/jnnp.2006.107995. Epub 2007 Feb 13.
We have gradually adopted a liberal attitude towards surgical decompression of arachnoid cysts. This study describes the results from our institution.
Long term clinical and neuroimaging results of 156 adult patients (aged > or = 16 years) operated on for arachnoid cysts in our department during the period January 1987 to September 2004 were assessed based on their medical and neuroimaging records, and on a questionnaire.
The clinical and/or neuroimaging results indicated that the cyst was successfully decompressed in all patients. 82% of patients were asymptomatic or had insignificant complaints at follow-up. 12% reported no symptom relief whereas 6% experienced worsening of symptoms. The cyst disappeared after surgery, or was reduced to < 50% of the preoperative volume, in 66% of cases. In another 24%, the postoperative volume was also reduced, but was larger than 50% of the original cyst volume. No reduction in fluid volume was observed in 10% of cases. There was no association between volume reduction and clinical improvement. A complication occurred in 26 patients (17%), all with temporal cysts, leading to reoperation in 11 patients (7.1%). In only two patients did the complication cause a permanent slight disability.
Decompression of arachnoid cysts yields a substantial clinical benefit with a low risk of severe complications.
我们对外科手术减压治疗蛛网膜囊肿已逐渐采取较为宽松的态度。本研究描述了我们机构的治疗结果。
根据1987年1月至2004年9月期间在我科接受蛛网膜囊肿手术的156例成年患者（年龄≥16岁）的病历和神经影像学记录以及一份调查问卷，对其长期临床和神经影像学结果进行评估。
临床和/或神经影像学结果表明所有患者的囊肿均成功减压。82%的患者在随访时无症状或仅有轻微不适。12%的患者报告症状未缓解，而6%的患者症状加重。66%的病例中囊肿在术后消失，或缩小至术前体积的<50%。在另外24%的病例中，术后囊肿体积也有所减小，但大于原始囊肿体积的50%。10%的病例中未观察到液体量减少。囊肿体积缩小与临床改善之间无关联。26例患者（17%）出现并发症，均为颞叶囊肿，其中11例患者（7.1%）因此接受了再次手术。仅2例患者的并发症导致了永久性轻度残疾。
蛛网膜囊肿减压可带来显著的临床益处，严重并发症风险较低。
