Institutional Experience Of Management Of Intracranial Arachnoid Cysts With Initial 72 Cases

Object.:Arachnoid cysts are commonly encountered fluid collections in the central nervous system. Recent advances in neuroimaging have translated into an increased detection of these cysts; That is diagnoses can be made more frequently at earlier stages. Significant advances have also been made in the surgical management of these lesions. The authors report on a case series that illustrates the diverse forms of presentation and the treatment modalities commonly used for arachnoid cysts. Between February 2007 and February 2010,72 patients with arachnoid cysts were confirmed on neuroimaging. Symptoms at presentation included headache, weakness, seizure, hydrocephalus, scoliosis, cognitive decline, and visual lose. Complications included spasticity, hemiparesis, cerebrospinal fluid leak, hydrocephalus, and subdural hygroma.There are 3 kinds of operation used including:cystosubarachnoid shunt(CS), cystoperitoneal shunt (CP) and neuroendoscopic cystic fenestration. We compared all the 3 methods, To analyze Which one of the most effective and find out the indication of treat by surgery.Methods:1. Collect the clinical data of IAC patients.2. Follow up of the patients and detect the change of symptoms and the imaging.3. Choose the suitable surgical indications by comparing the data.Result:All the 72 patients are diagnosed of IAC after brain CT scan,49 patients under went surgery, while the other 23 patients did not undergo operation. CTC was taken in 32 cases in which 24 cases were CIAC and 8 Cases were NCIAC. After surgery, all the patient's clinical symptoms improved to different degrees. Conclusions:1. IAC patients can be classified into CIAC and NCI AC cases. The technology of CTC is specific for making a final diagnosis of IAC.2. To choose the most appropriate surgery method is the key to improve the cure rate and decrease complications.3. In comparison with traditional treatments, neuroendoscopic cystic fenestration seems to represent an effective, minimally invasive, few complications and low risk surgical procedure.