Management of Symptomatic Middle Cranial Fossa Arachnoid Cysts
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- Category: Vol. 85, September 2017
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Management of Symptomatic Middle Cranial Fossa Arachnoid Cysts, WALID EISSA EL-HALABY and MOHAMED I. REFAAT
Abstract
Object: Arachnoid cysts account for 1% of all intracranial lesions, of which; middle cranial fossa (Sylvian) cysts comprise approximately 49% of all intracranial arachnoid cysts. Only symptomatic arachnoid cysts should be treated either with cyst fenestration using endoscope or microscope and/or shunt placement. This study evaluates the role of fenestration and shunt placement in these patients.
Methods: This study was conducted, prospectively, on 18 pediatric patients with symptomatic middle cranial fossa (Sylvian) arachnoid cysts. Cyst fenestration (either endoscopic or microscopic) was performed first, then shunt placement was performed in the following indications: 1- Manifestations of increased intracranial pressure. 2- CSF leak from the wound. 3- Progressive increase in the cyst's size on follow-up. 4- subdural hygroma.
Results: 3 patients (16.6%) required shunt placement after cyst fenestration, a higher percentage of younger age patients were noticed to need shunt placement after fenestration.
Conclusion: Endoscopic or microscopic fenestration is a reliable procedure for treatment of symptomatic middle cranial fossa (Sylvian) arachnoid cysts, whereas shunt placement is considered a better option in younger patients.