Surgical Treatment Of Intracranial Arachnoid Cysts (35Cases Report)

Objective:In order to investigate the clinical features, operating with indications andoperational modes of intracranial arachnoid cyst. Summing up the operational skills canpromote resection rate of cyst and lower recurrence rate.Method:In the scend Department of Neurosurgery Ward of the First Affiliated Hospital ofDalian Medical University, from2003February to2014February, we analyzeretrospectively Results after conventional data, clinical characteristics, auxiliaryexamination results, operational modes and operation of collectting35cases who getintracranial arachnoid cysts and operational treatment. In10cases do adjustable shunttube cyst-peritoneal shunt. In20cases doing cyst-peritoneal shunt choose mid-pressureshunt equipment with anti-siphon.Other5cases with cyst excision plus cisterncommunication surgery with Neural endoscopic,5cases’cyst walls were excised andmake cyst communicated with Intraventricular and cisternal.5cases get with epilepsy.Results:All the patients have successful operation process, without serious complications. In10cases with adjustable shunt tube cyst-peritoneal shunt,4postoperative casesregulated18times,including raising9times and cutting9times, the original symptomsdisappeared or improved.3cases of10cases with adjustable shunt tube cyst-peritonealshunt get epilepsy.1cases’epilepsy have no obvious improvement. After regulating8times,including raising4times and cutting4times, the cases’ original symptom isimproved.In10cases with adjustable shunt tube cyst-peritoneal shunt, their originalsymptoms have obvious improvement (accounting for100%). All have no relapse afterthe operation. In20cases with cyst-peritoneal shunt choosing mid-pressure shuntequipment with anti-siphon,18cases’ original symptoms have improvement afteroperation,that is accounted for90%,2cases’ original symptoms have no significantimprovement after operation. It is accountted for10%. In4cases of20cases doingcyst-peritoneal shunt choosing mid-pressure shunt equipment with anti-siphon getepilepsy, one cases’ original symptom is disappeared; Other5cases with cyst excisionplus cistern communication surgery with Neural endoscopic, including5cases withepilepsy.5cases’ original symptoms get improvement after operation,it is accountedfor100%; All cases have no relapse after the operation.Conclusion:1. Recently,with popularity of advanced imaging equipment in clinical andpeople’s health consciousness enhanced, we found that the discovery rate of intracranialarachnoid cysts and the rate of operational treatment ratio get upward trend2. Operational indications of Arachnoid cyst so far have no common standard.Atpresent, the size of the cyst,patients with symptoms,Situation of the surrounding tissuecompression,Physical condition of patients and cyst types decide operation; Pediatricpatients with operational indications may be appropriate to relax.3. The specific patient with cyst,the growth position of cyst,The age of thepatients，the operators’ operational level and other considerations,we can choose thebest method of operation. About the operational treatment of patients with intracranialarachnoid cysts complicated with epilepsy, cyst excision plus cistern communicationsurgery with Neural endoscopic has more advantages than cyst-peritoneal shunt. But adjustable shunt tube cyst-peritoneal shunt has more obvious advantages thancyst-peritoneal shunt choosing mid-pressure shunt equipment with anti-siphon andmicro cyst excision and cistern fistulization with Neural endoscopic in results ofsimple operation, small Surgical trauma, postoperative operability, reusable tools ofadjustable pressure, short operating time, good postoperative operation, lesspostoperative complications, lower recurrence rate of cysts and other aspects.,so that hefirst surgical treatment should be adjustable shunt tube cyst-peritoneal shunt.