Duz Bulent, Kaya Serdar, Daneyemez Mehmet, Gonul Engin
Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2012;22(5):591-8. doi: 10.5137/1019-5149.JTN.5616-11.0.
Arachnoid cysts are benign intra-arachnoid cystic lesions filled with cerebrospinal fluid. With advent of modern treatment techniques, debate continues regarding which surgical treatment is most effective. MATERIAL and
A consecutive series of 75 patients with arachnoid cysts that were surgically treated between January 1992 and December 2009 are reported. Included in the study were 54 male and 21 female patients, ranging in age from 2 months to 45 years (mean age 20.02 years) at the time of surgery. Symptoms at presentation, location on the cysts, and treatment modalities were evaluated.
Headache was controlled in 92.5% of adult cases. Hydrocephalus, cognitive decline weakness and gait disturbances were controlled 100% after overall treatment methods. Follow-up CT scans showed significant reduction in cyst size in supratentorial arachnoid cysts. No significant changes in cyst size were found in infratentorial cysts but symptomatic improvements were noted.
Patients with symptomatic arachnoid cysts regardless of age and cyst location should be treated. We think that avoiding shunt dependence should be one of the principle treatment goals. Proper patient selection results in good outcomes.
蛛网膜囊肿是充满脑脊液的良性蛛网膜内囊性病变。随着现代治疗技术的出现,关于哪种手术治疗最有效仍存在争议。
报告了1992年1月至2009年12月期间连续接受手术治疗的75例蛛网膜囊肿患者。研究纳入54例男性和21例女性患者,手术时年龄从2个月至45岁不等(平均年龄20.02岁)。对就诊时的症状、囊肿位置及治疗方式进行了评估。
92.5%的成年病例头痛得到控制。总体治疗方法后,脑积水、认知功能减退、虚弱和步态障碍得到100%控制。随访CT扫描显示幕上蛛网膜囊肿大小显著减小。幕下囊肿大小无显著变化,但症状有改善。
有症状的蛛网膜囊肿患者,无论年龄和囊肿位置如何,均应接受治疗。我们认为避免依赖分流术应是主要治疗目标之一。正确选择患者可取得良好疗效。