Biomedical Engineering Reference
In-Depth Information
Endoscopic Treatment of Arachnoid Cyst
Y. R. Yadav, Vijay Parihar and Pushpraj Bhatele
Abstract Introduction The surgical options for symptomatic arachnoid cysts are
shunting, endoscopic fenestration, and craniotomy with fenestration. The endo-
scopic procedure has been found to be minimally invasive, safe, and effective.
Results of endoscopic treatment of 21 patients of arachnoid cyst in vicinity to
cistern or ventricle are described. Material and Methods All except one of the
symptomatic arachnoid cysts with raised intracranial pressure were operated by
endoscopic procedure. One patient of convexity cyst without any adjoining cistern/
ventricle was excluded from study. Gaab 6-degree rigid telescope was used. Burr
hole was made keeping in mind the straight trajectory between the cyst and cistern/
ventricle. A minimum of 1 cm hole was made in all the cases. Third ventriculos-
tomy was also done for associated hydrocephalus in quadrigeminal arachnoid cyst.
Both the procedures could be done by single burr hole placed about 3-4 cm anterior
to coronal suture. Results This is a prospective study of 21 arachnoid cysts. There
were 6, 8, 5, and 2 cases of vermian, quadrigeminal region, sylvian fissure region,
and cerebello-pontine region arachnoid cyst respectively. Symptomatic improve-
ment occurred in 20 cases, while one infant with quadrigeminal arachnoid cyst
required a ventriculo-peritoneal (VP) shunt. There was no mortality or any other
complication except 3 cases of CSF leak, which stopped in 7 days time in two
cases. Third ventriculostomy was done in the same sitting in 8 cases of quadri-
geminal region arachnoid cyst. Follow-up ranged from 6 to 54 months. Conclusion
Endoscopic treatment of arachnoid cyst with an adjoining cistern or ventricle is safe
and effective. Third ventriculostomy can be done in the same sitting.
Y. R. Yadav (
&
)
V. Parihar
NSCB Medical College and MP MRI Centre, Jabalpur, Madhya Pradesh, India
e-mail: yadavyr@yahoo.co.in
P. Bhatele
Department of Neurosurgery and Radio diagnosis, NSCB Medical College and MP MRI
Centre, Jabalpur, Madhya Pradesh, India
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