Surgical Treatment Strategy For Intracranial Arachnoid Cyst In Children

Objective To explore the treatment strategy and clinical efficacy of different surgical methods for children with intracranial arachnoid cysts,and to obtain the best surgical treatment and guide clinical diagnosis and treatment..Methods From January 2011 to December 2018,22 children with intracranial arachnoid cysts diagnosed as arachnoid cysts by neurosurgery in the General Hospital of Ningxia Medical University and the Hospital of Cardiovascular and Cerebrovascular Diseases were treated with 16-row CT and 1.5T craniocerebral magnetic resonance imaging(MRI),electrocardiogram,electroencephalogram and lumbar puncture before operation.The children were divided into two groups according to different surgical methods: cyst-peritoneal shunt group(14 cases),cystostomy group(8 cases),including endoscopic cystostomy(1 case),microscopic cystostomy(7 cases),and follow-up from 3 months to 24 months.The effective rate of surgical methods,the incidence of short-term and long-term complications,the average length of stay and the change of cyst volume were analyzed retrospectively.Results After 3 months to 2 years of follow-up,the effective rate of cyst-peritoneal shunt was 85.71%(12/14 cases).The rate of recent complications after cyst-peritoneal shunt was 14.29%(2/14 cases)),1 case of intracranial infection and incision healing;the long-term complication rate was 14.29%(2/14 cases),including 1 case of shunt skin channel infection with shunt tube,and shunt tube 5 years after surgery.Once the headache recurred,the shunt tube should be placed again,that is,the shunt tube relied on 1 case.The effective rate of ostomy group(including microscopic cyst ostomy and endoscopic cyst stenosis)was 87.50%(7/8 cases);the postoperative complication rate was 25.00%(2/8 cases).There were 1 case of subdural hematoma and 1 case of intracranial infection.The postoperative long-term complication rate was 12.50%(1/8 cases): 1 case of epileptic seizure occurred 2 years after operation.There was no significant difference in the effective rate between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two operations(P>0.05).Both surgical methods can improve the clinical symptoms of the children,and there may be complications in the near future.There was no significant difference in long-term complications between the two operations(P>0.05).There were significant differences in the changes of cyst volume between the two surgical methods before and after operation(P<0.05).No matter which surgical method was adopted,the cysts could be reduced to different extents.The final reduction of cysts was statistically significant(P<0.05).The final cyst shrinkage rate and volume were better than ostomy.The average hospital stay of the two procedures was statistically significant(P < 0.05),and the average hospital stay for cyst-peritoneal shunt was lower than the average hospital stay for cystic fistula.Conclusion There was no significant difference in the operative efficiency between peritoneal and fistula,which was effective in the treatment of arachnoid cyst in children.