Cystoperitoneal Shunting for Congenital Arachnoid Cysts

Kaplan, Berkan; Mickle, J. Parker; Parkhurst, R

doi:10.1159/000120192

Cited by 32 publications

(21 citation statements)

References 6 publications

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“…When the cyst is complicated by ventricular dilatation, the ventricles should be shunted together with the cyst, as advocated by Kaplan et al 9. Our series supports Winston's recommendation 16 that it is of importance to connect both the ventricular and the cyst shunt through the same pressure regulating valve, otherwise there exists a risk of intracranial pressure fluctuation and herniation.…”

Section: Discussionsupporting

confidence: 76%

Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood

et al. 1985

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Widely diverging opinions on the optimal therapy for intracranial cerebrospinal fluid cysts (CSF), mainly arachnoid cysts and the Dandy-Walker cysts, exist. Excision of the cyst walls in the treatment of the Dandy-Walker cyst has been replaced by shunting procedures, but the recommended method for primary treatment of arachnoid cysts in childhood is still cyst wall excision. Membrane excision is, however, often complicated by recurrence, subsequently requiring shunting-procedures. In a series of 19 cases primary shunting of intracranial CSF cysts proved to be a reliable method. In those cases where hydrocephalus (ventricular dilatation) is present at the time of the primary operation the ventricles should be shunted as well as the cyst. The catheter from the ventricle and that from the cyst should be connected to the same valve, otherwise an increased risk of intracranial herniation exists. The prognosis for infants and children suffering from intracranial CSF cysts is in general good; in 17 out of 19 cases mental development was normal and in 15 out of 19 motor development was normal. The risk of permanent motor damage seems to be particularly high when an arachnoid cyst is located on the quadrigeminal plate.

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Section: Discussionsupporting

confidence: 76%

Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood

et al. 1985

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“…The "endoscopic" group (including our cases) was treated by fenestration through a suboccipital supracerebellar approach (2 cases) [3], lateral ventricle cystostomy (9 cases) [5,6] and third ventricle−cystostomy (5 cases) [4,6,7]. The "surgical" group was treated by craniotomy and cyst fenestration or excision (6 cases) [10,17,19 ± 21] ventricular shunt (5 cases) [11,14,18], shunt of the cyst (one case) [16], shunt of both cyst and ventricles (4 cases) [11,15,16], craniotomy and cyst fenestration with shunt of ventri− cular system (2 cases) [12,13] or of both cyst and ventricles (2 cases) [14,16].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Treatment of Quadrigeminal Cistern Arachnoid Cysts

Gangemi

Maiuri

Colella

et al. 2005

Minim Invasive Neurosurg

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Five patients with arachnoid cysts of the quadrigeminal cistern treated by endoscopic fenestration are reported and another eleven well-documented cases from the literature are reviewed. Among the five personal cases four were children and one was adult; the cyst fenestration was performed from the lateral ventricle in three cases and from the third ventricle in two. In four patients the endoscopic treatment resulted in clinical remission, whereas a two-month-old baby later required a shunt. The lateral ventricle-cystostomy and the third ventricle-cystostomy (according to the cyst extent) are the best endoscopic procedures, whereas the cyst fenestration through a suboccipital supracerebellar approach is no longer used. The rate of cured or improved patients after endoscopic surgery (14/16 or 87.5%) was rather similar to that of a group of twenty patients treated by traditional surgery (craniotomy and cyst excision and/or shunt) (85%). These data confirm that endoscopic fenestration of quadrigeminal cistern cysts must be performed as the first procedure because it is less invasive and avoids shunt dependency.

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“…The proponents for shunting have argued that: (a) shunting is a simpler procedure [23,31], (b) the risks and complications are fewer, (c) it allows gradual reexpan sion of brain [31], (d) craniotomy is a major procedure [32], and (e) not all patients treated by craniotomy are cured and patients may still need a shunt [32].…”

Section: Discussionmentioning

confidence: 99%

Congenital Arachnoid Cysts in Children

Balsubramaniam

Laurent²,

Rouah³

et al. 1989

Pediatr Neurosurg

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Congenital arachnoid cysts (CAC) are benign developmental disorders. A number of theories have been proposed to explain the origin and progression to the symptomatic stage. Management strategies range from not treating the asymptomatic cysts to craniotomy, excision of cyst wall and establishment of a communication with the adjacent subarachnoid cistern or ventricle. Other lesions may resemble CAC, and can be differentiated from CAC only by a critical review of the biopsy specimen. We have reviewed our experience with true CAC and similar lesions. Based on our experience we recommend craniotomy, excision of cyst wall and establishment of a communication with an adjacent subarachnoid cistern or ventricle as the primary procedure.

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Cystoperitoneal Shunting for Congenital Arachnoid Cysts

Cited by 32 publications

References 6 publications

Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood

Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood

Endoscopic Treatment of Quadrigeminal Cistern Arachnoid Cysts

Congenital Arachnoid Cysts in Children

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