• World Neurosurg · Sep 2015

    Endoscopic Treatment of Temporal Arachnoid Cysts in 34 Patients.

    • Tim Couvreur, Giorgio Hallaert, Tatjana Van Der Heggen, Edward Baert, Frank Dewaele, Jean-Pierre Kalala Okito, Dimitri Vanhauwaert, Marc Deruytter, Dirk Van Roost, and Jacques Caemaert.
    • Department of Neurosurgery, Ghent University Hospital, Ghent, Belgium; Department of Neurosurgery, AZ Delta, Roeselare, Belgium. Electronic address: Tim.Couvreur@UGent.be.
    • World Neurosurg. 2015 Sep 1; 84 (3): 734-40.

    IntroductionArachnoid cysts are lesions present in 1% of the population and usually found in the temporal fossa. Clinical and radiologic presentations can differ greatly. Despite intensive research, it is still debatable which patients will benefit from surgery.ObjectiveThis study aims to investigate the pretreatment parameters influencing the outcome after neuroendoscopic treatment of temporal arachnoid cysts.Materials And MethodsA retrospective analysis of 34 patients who underwent an endoscopic fenestration of a temporal arachnoid cyst between July 1991 and December 2013 was performed.ResultsIn symptomatic patients, there was a clinical improvement in 76.4% of cases. The best results were found in treating symptoms related to intracranial hypertension, acute neurologic defects, and macrocrania. Patients with temporal lobe epilepsy improved after cyst fenestration in 33.3% of cases. Behavioral problems and psychomotor retardation remained largely unchanged. Patients with a complex neurologic presentation, often from a congenital syndrome and combined with an intellectual disability, had the least benefit from endoscopic surgery. Radiologic follow-up showed a cyst volume decrease in 91.2% of cases. Complications were present in 29.4%, but were mostly minor and transient.ConclusionThis study demonstrates that patients with symptoms related to intracranial hypertension, acute neurologic deficits, and macrocrania have the best postoperative outcome. Also, patients with ipsilateral temporal lobe epilepsy seem to be good candidates for endoscopic arachnoid cyst fenestrations. In complex neurologic disorders without one of the previously mentioned symptoms, endoscopy remains less successful.Copyright © 2015 Elsevier Inc. All rights reserved.

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