Intracranial arachnoid cysts - Clinical features and management of 35 cases and review of the literature


NEUROSURGERY QUARTERLY, cilt.14, ss.84-89, 2004 (SCI İndekslerine Giren Dergi) identifier identifier


The purpose of this study is to evaluate the distribution, clinical features, and treatment modalities of arachnoid cysts (ACs) in our clinic. The study was carried out between January 1, 1996 and November 31, 2002 at the Neurosurgery Department of Cukurova University Hospital, Adana, Turkey. Thirty-five patients (13 female and 22 male) with ACs demonstrated by cranial magnetic resonance imaging or computed tomography during this period were enrolled and discussed in this study. The middle cranial fossa was the most common location of ACs; ACs were located in the middle cranial fossa in 22 (62.9%) cases, followed by the cerebellopontine angle in 4 (11.4%) cases, the cerebral convexity in 3 (8.6%) cases, the suprasellar region in 2 (5.7%) cases, the quadrigeminal cisterns in 2 (5.7%) cases, and the retrocerebellar region in 2 (5.7%) cases. All cysts were unilateral: 25 (71.4%) were located on the left side, and 10 (28.6%) were located on the right side. The mean age at onset of clinical manifestations was 3 years, 6 months (range: 1 month to 12 years). The mean age at diagnosis was 8 years (range: 1-32 years). The most frequent clinical features on presentation were epileptic seizures (42.9%) and headache (28.6%). A few patients (9 [25.7%]) underwent surgery. Surgical intervention with microsurgical excision and fenestration was performed in 7 patients, and cystoperitoneal shunting was performed in 2 patients. The major indications for surgery of ACs are intractable seizures, intracranial hypertension, and compression of neuronal tissues. Headache only is not a surgical indication. Microsurgical excision and fenestration are safe and effective for the surgical treatment of ACs.