Suprasellar Cysts: Surgical Treatment and Results

Raimondi, Anthony J.; Shimoji, Takeyoshi; Gutiérrez, Francisco

doi:10.1159/000119929

Cited by 37 publications

(14 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The options are no intervention in asymp tomatic patients, simple aspiration, burr hole and fenes tration, placing a shunt, ventriculocystostomy, cranio tomy with wide excision of the membrane and establish ment of communication with the subarachnoid cisterns [6,11,14,22,34,43,45], Some advocate not operating on asymptomatic cyst [8,13,19,43], some operating on all patients [27], Once the decision to operate has been made, radiological evaluation is employed to aid in the treatment [3,9,10,13,19,27,46,52]. Among the various surgical options available the merits and demerits of shunting and craniotomy have been strongly debated [27,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Congenital Arachnoid Cysts in Children

Balsubramaniam

Laurent²,

Rouah³

et al. 1989

Pediatr Neurosurg

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Congenital Arachnoid Cysts in Children

Balsubramaniam

Laurent²,

Rouah³

et al. 1989

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…2,7 A similar percentage of patients with suprasellar cysts may show visual impairment. 2,6,21,24 In children, arachnoid cysts often produce mild neurological impairment relative to their large size, as seen in many of the patients in this series who had large sylvian cysts but no focal neurological deficits.…”

Section: Discussionmentioning

confidence: 72%

“…20 The clinical manifestations of arachnoid cysts are variable and often unspecific. 14,[21][22][23][24][25][26] The most common presenting symptoms and signs are those of raised intracranial pressure, craniomegaly, and developmental delay. 7,10 They are usually seen in cases of large supratentorial cysts, but may also be caused by smaller suprasellar or posterior fossa cysts associated with obstructive hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

“…7,10 They are usually seen in cases of large supratentorial cysts, but may also be caused by smaller suprasellar or posterior fossa cysts associated with obstructive hydrocephalus. [21][22][23][24] Focal neurological deficits and epilepsy are present in less than 30% of patients with middle fossa arachnoid cysts. 2,7 A similar percentage of patients with suprasellar cysts may show visual impairment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intracranial Arachnoid Cysts: Treatment Alternatives and Outcome in A Series of 25 Patients

Jamjoom

1997

Ann Saudi Med

View full text Add to dashboard Cite

A series of 25 patients with intracranial arachnoid cysts is analyzed retrospectively. There were 14 males and 11 females ranging in age between a few days and 58 (mean 10) years. Seventy-six percent of patients were children below the age of 15 years. Most of the patients presented with symptoms and signs of long-standing raised intracranial pressure, while localizing signs were rather uncommon. The clinical manifestations were often mild relative to the large size of the cyst. Associated hydrocephalus was present in three patients: one with suprasellar cyst and two with posterior fossa cysts. Seven patients with mild symptoms and small cysts were treated conservatively, while the remaining 18 patients underwent surgical treatment. The initial surgical procedure consisted of craniotomy and fenestration of the cyst in three patients, and cystoperitoneal shunting in the other 15. Of the three patients who underwent craniotomy, one improved postoperatively, while the remaining two developed complications consisting of wound infection and postoperative epilepsy in one and permanent severe neurological deficit in the other. In contrast, six of the 15 cysts treated by shunting resolved completely, eight were smaller, and one remained unchanged. Radiological regression of the cyst after shunting was associated with various degrees of clinical improvement in 13 patients (87%). Two (13%) of 15 shunted patients developed complications in the early postoperative period, consisting of wound infection in one and early shunt failure in the other. Three patients (20%) with shunts had late complications during the follow-up period, consisting of recurrent shunt failure in the first, subdural hematoma in the second, and perforation of the peritoneal catheter into the hepatic bile ducts in the third. These findings, as well as recent data from the literature, suggest that in the management of intracranial arachnoid cysts, cystoperitoneal shunting was more effective and had fewer serious complications than craniotomy and cyst fenestration, and therefore, it is recommended as the treatment of first choice. Ann Saudi Med 1997; 17(3) Arachnoid cysts are non-tumorous intra-arachnoid fluid collections that account for about 1% of all intracranial space-occupying lesions.1 They may develop thoughout the cerebrospinal axis, with a predominance in the sylvian region.2,3 Because of their benign nature and slow expansion, arachnoid cysts may remain symptomatic or produce only subtle symptoms and signs. On the other hand, they sometimes give rise to focal neurological deficits, raised intracranial pressure, and/or epileptic seizures. The question of when these lesions should be operated upon is, therefore, not always easy to answer. Moreover, the choice of the most appropriate surgical approach is still debated. 2,[4][5][6][7][8] In the following report, the author describes the clinical and radiological findings in 25 patients with intracranial arachnoid cysts. In addition, the treatment results are analyzed and compared with those publish...

show abstract

“…The role of LM, as any other arachnoid membrane, in the formation of SSAC has been described in literature [5,[45][46][47][48].…”

Section: Suprasellar Arachnoid Cystsmentioning

confidence: 99%