Endoscopic Treatment of Arachnoid Cyst
Introduction The surgical options for symptomatic arachnoid cysts are shunting, endoscopic fenestration, and craniotomy with fenestration. The endoscopic procedure has been found to be minimally invasive, safe, and effective. Results of endoscopic treatme
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Abstract Introduction The surgical options for symptomatic arachnoid cysts are shunting, endoscopic fenestration, and craniotomy with fenestration. The endoscopic procedure has been found to be minimally invasive, safe, and effective. Results of endoscopic treatment of 21 patients of arachnoid cyst in vicinity to cistern or ventricle are described. Material and Methods All except one of the symptomatic arachnoid cysts with raised intracranial pressure were operated by endoscopic procedure. One patient of convexity cyst without any adjoining cistern/ ventricle was excluded from study. Gaab 6-degree rigid telescope was used. Burr hole was made keeping in mind the straight trajectory between the cyst and cistern/ ventricle. A minimum of 1 cm hole was made in all the cases. Third ventriculostomy was also done for associated hydrocephalus in quadrigeminal arachnoid cyst. Both the procedures could be done by single burr hole placed about 3–4 cm anterior to coronal suture. Results This is a prospective study of 21 arachnoid cysts. There were 6, 8, 5, and 2 cases of vermian, quadrigeminal region, sylvian fissure region, and cerebello-pontine region arachnoid cyst respectively. Symptomatic improvement occurred in 20 cases, while one infant with quadrigeminal arachnoid cyst required a ventriculo-peritoneal (VP) shunt. There was no mortality or any other complication except 3 cases of CSF leak, which stopped in 7 days time in two cases. Third ventriculostomy was done in the same sitting in 8 cases of quadrigeminal region arachnoid cyst. Follow-up ranged from 6 to 54 months. Conclusion Endoscopic treatment of arachnoid cyst with an adjoining cistern or ventricle is safe and effective. Third ventriculostomy can be done in the same sitting.
Y. R. Yadav (&) V. Parihar NSCB Medical College and MP MRI Centre, Jabalpur, Madhya Pradesh, India e-mail: [email protected] P. Bhatele Department of Neurosurgery and Radio diagnosis, NSCB Medical College and MP MRI Centre, Jabalpur, Madhya Pradesh, India
V. Kumar and M. Bhatele (eds.), Proceedings of All India Seminar on Biomedical Engineering 2012 (AISOBE 2012), Lecture Notes in Bioengineering, DOI: 10.1007/978-81-322-0970-6_4, Ó Springer India 2013
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Keywords Arachnoid cyst
Y. R. Yadav et al.
Neuro endoscopic Endoscopic treatment
Introduction The optimal surgical treatment for symptomatic arachnoid cysts is controversial. Therapeutic options include cyst shunting [1–5], endoscopic fenestration [6–11], and craniotomy for fenestration [12–14]. Endoscopy is having an increasingly prominent role in neurosurgery. The endoscopic procedure has been found to be minimally invasive, safe, and effective as compared to the traditional surgical craniotomy [15–20]. We are reporting our experience of endoscopic treatment of 21 arachnoid cysts.
Material and Methods All the symptomatic patients of arachnoid cysts except one were operated by endoscopic procedure between Jan 2004 and Feb 2008. One patient of convexity cyst without any adjoining cistern/ventricle was managed by cystoperi
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