Our first experience in endoscopic treatment of cerebral arachnoid cysts at children
https://doi.org/10.17650/1683-3295-2014-0-2-73-77
Abstract
Objective: to determine the optimal method for treatment of cerebral arachnoid cysts at children. Material and methods: This study includes 19 children at the age from 2 months till 12 years old, treated at the base of Federal Neurosurgical center in Novosibirsk (Russian Federation) within period from December 2012 till August 2013. The microsurgical cyst fenestration was chosen as primary treatment method at 5 children. Two patients underwent cystoperitoneal shunting. The endoscopic cyst fenestration was performed at 12 patients. The endoscopic treatment methods were prioritized however the microsurgical surgery was done in several cases under conditions of impossibility of safe endoscopic cyst fenestration. Results: The positive result was achieved in all cases with regress of neurological deficit in several weeks and decreased or disappearance of seizures. Postoperative brain MRI revealed the decrease of cyst dimensions at 14 (73,7%) patients. The small subdural hydroma with no indications for surgical removal was seen at one child. One patient underwent ventriculoperitoneal shunting in 2 months after microsurgical fenestration of posterior cranial fossa cyst because of hydrocephalus advance. Conclusion: The short-term results of conducted treatment allow insisting that appropriate cyst fenestration permits to avoid the implantation of ventriculoperitoneal shunt with its possible complications.
About the Authors
G. V. Letiagin
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation
Russian Federation
S. A. Kim
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation
Russian Federation
A. A. Sysoeva
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation
Russian Federation
V. E. Danilin
ФГБУ «Федеральный центр нейрохирургии»
Russian Federation
Russian Federation
References
1. Меликян А.Г., Коршунов А.Е., Кушель Ю.В. Гидроцефалия и церебральные кисты // Современные технологии и клинические исследования в нейрохирургии. Под редакцией акад. А.Н. Коновалова. М., ИП «Т.А. Алексеева», 2012. Гл. 21. - С. 411-423.
2. Ростовцев Д.М. Особенности хирургического лечения арахноидальных кист головного мозга у детей: Автореф. дис.. канд.мед.наук / ФГУ РНХИ им. проф. А.Л. Поленова, СПб., 2008.
3. Самочерных К.А., Хачатрян А.В., Ким А.В., Иванов И.В. Особенности хирургической тактики при арахноидальных кистах большого размера // Креативная хирургия и онкология. - 2011, № 1; С. 77-82.
4. Ciricillo S.F., Cogen P.H., Harsh G.R., Edwards M.S. Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting // J Neurosurg. - 1991. - Vol. 74 (2). - P. 230-235.
5. Duz B., Kaya S., Daneyemez M., Gonul E. Surgical management strategies of intracranial arachnoid cysts: a single institution experience of 75 cases // Turk Neurosurg. - 2012. - Vol. 22 (5). - P. 591-598.
6. El-Ghandour N.M. Endoscopic cyst fenestration in the treatment of uniloculated hydrocephalus in children // J Neurosurg Pediatr. - 2013. - Vol. 11 (4). - P. 402-409.
7. Fewel M.E., Levy M.L., McComb J.G. Surgical treatment of 95 children with 102 intracranial arachnoid cysts // Pediatr. Neurosurg. - 1996. - Vol. 25 (4). - P. 165-173.
8. Gangemi M., Seneca V., Colella G., Cioffi V., Imperato A., Maiuri F. Endoscopy versus microsurgical cyst excision and shunting for treating intracranial arachnoid cysts // J. Neurosurg. Pediatr. - 2011. - Vol. 8 (2). - P. 158-164.
9. Greenberg, Mark S. Handbook of Neurosurgery // Thieme, 2006. - P. 94-96.
10. Inamasu J., Ohira T., Nakamura Y., Saito R., Kuroshima Y., Mayanagi K., Ohba S., Ichikizaki K. Endoscopic ventriculocystomy for non-communicating hydrocephalus secondary to quadrigeminal cistern arachnoid cyst // Acta Neurol. Scand. 2003. - Vol. 107 (1). - P. 67-71.
11. Harsh G.R. 4th, Edwards M.S., Wilson C.B. Intracranial arachnoid cysts in children // J. Neurosurg. - 1986. - Vol. 64 (6). - P. 835-842.
12. Hinojosa J., Esparza J., Mucoz M.J., Valencia J. Endoscopic treatment of suprasellar arachnoid cysts // Neurocirugia (Astur). - 2001. - Vol. 12 (6). - P. 82-88.
13. Kang J.K., Lee K.S., Lee I.W., Jeun S.S., Son B.C., Jung C.K., Park Y.S., Lee S.W. Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children // Childs Nerv. Syst. - 2000. - Vol. 16 (2). - P. 111-116.
14. Lee E.J., Ra Y.S. Clinical and neuroimaging outcomes of surgically treated intracranial cysts in 110 children // J. Korean Neurosurg. Soc. - 2012. - Vol. 52 (4). - P. 325-533.
15. Levy M.L., Wang M., Aryan H.E., Yoo K., Meltzer H. Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration // Neurosurgery. - 2003. - Vol. 53(5).
16. Mattox A., Choi J.D., Leith-Gray L., Grant G.A., Adamson D.C. Guidelines for the management of obstructive hydrocephalus from suprasellar-prepontine arachnoid cysts using endoscopic third ventriculocystocisternostomy // Surg. Innov. - 2010. - Vol. 17 (3). - P. 206-216.
17. Pradilla G., Jallo G. Arachnoid cysts: case series and review of the literature // Neurosurg. Focus. - 2007. - Vol. 15 (22).
18. Raffel C., McComb J.G. To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? // Neurosurgery. - 1988. - Vol. 23 (3). - P. 338-342.
19. Tamburrini G., D’Angelo L., Paternoster G., Massimi L., Caldarelli M., Di Rocco C. Endoscopic management of intra and paraventricular CSF cysts // Childs Nerv. Syst. - 2007. - Vol. 23 (6). - P. 645-651.
20. Tamburini G., Del Fabbro M., Di Rocco C. Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management // Childs Nerv. Syst. - 2008. - Vol. 24. - P. 593-604.
Review
For citations:
Letiagin G.V., Kim S.A., Sysoeva A.A., Danilin V.E. Our first experience in endoscopic treatment of cerebral arachnoid cysts at children. Russian journal of neurosurgery. 2014;(2):73-77. (In Russ.) https://doi.org/10.17650/1683-3295-2014-0-2-73-77
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