Surgical Treatment Of Intracranial Arachnoid Cysts (36 Cases Report)

Objective:To investigate the clinical characteristics, surgical indications and surgical methods of intracranial arachnoid cysts. Summary of surgical techniques can improve the success rate and lower recurrence rate.Method:In our hospital from January 2000 to December 2010, we collect 36 cases with intracranial arachnoid cysts of surgical treatment, whose general information, clinical manifestations, imaging data, treatment and curative effects are analyzed retrospectively. In 10 cases with microscopic cyst excision plus cistern communication surgery, we resect the cyst wall tissue firstly,and then we communicate between cyst cavity and subarachnoid space, cisterns or ventricles, including 3 cases with epilepsy (2 cases do epilepsy foci resection, a case does bipolar coagulation electrocoagulation of subcortical surgery). Other 26 cases do cyst-peritoneal shunt, most of which choose low-pressure shunt equipment with non-anti-siphon.Results:All patients are successful during operation, who have not severe complications after surgery. In 10 cases with microscopic cyst excision plus cistern communication surgery, their original symptoms were improved more or less, including 3 cases with epilepsy no longer having seizures. All of 10 cases have no recurrence. In 26 cases with cyst-peritoneal shunt, 22 cases'original symptoms are disappeared or improved after surgery (accounting for 84.6%), 4 cases'original symptoms have no significant changes (accounting for 15.4%). In 8 cases with epilepsy of 26 cases with cyst-peritoneal shunt, 2 cases'the original symptoms are disappeared, 4 cases'the original symptoms are improved, 2 cases have no significant changes. 3 cases with cyst-peritoneal shunt recurred after surgery, recurrence rate is about 11.5%.Conclusion:1. Intracranial arachnoid cyst is a kind of intracranial non-neoplastic benign lesion. In recent years, with the advanced imaging technology used in clinical widely and people's growing awareness of self-care, it's morbidity and the proportion of surgerial treatment cases have an increasing trend.2. The surgical indication of intracranial arachnoid have no uniform standard currently. We should decide whether doing operation for a patient, according to the type of arachnoid cyst, whether having a growth of cysts'volume, important brain structures'damage, clinical symptoms and other aspects. In the developmental stages of children, surgical treatment should be active relatively .3. The choice of surgical approach of intracranial arachnoid cysts should be based on cyst location, the special nature of disease, surgical proficiency and other factors considered. Microscopic cyst excision plus cistern communication surgery has more obvious advantages than cyst-peritoneal shunt in results of operations, postoperative complications, recurrence rate of cysts and other aspects. When the patient is intracranial arachnoid cyst with epilepsy, the first surgical treatment should be microscopic cyst excision plus cistern communication surgery.