Neuroendoscopic treatment of arachnoid cysts in cisterna magna via CSF-orientated fenestration

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Author:
SUN Tao(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
WANG Fei(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
YU Hua-lin(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
LI Jing-hui(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
YAO Xiao-yan(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
MA Yi-liu(Minimally Invasive Neurosurgery Department, The First Affiliated Hospital of Kunming Medical College,Kunming 650032, China)
Journal Title:
Chinese Journal of Neurosurgery
Issue:
Volume 28, Issue 03, 2012
DOI:
10.3760/cma.j.issn.1001-2346.2012.03.004
Key Word:
Arachnoid cysts;Neuroendoscopy;CSF;Dynamics

Abstract: Objective To specify fenestration site for arachnoid cysts in cisterna magna according to CSF dynamics by reviewing these neuroendoscopically treated cases in our department.Methods According to lesion locations and CSF dynamics,twenty - seven cases surgically indicated were fenestrated to either of quadrigeminal cistern and supracerebellar cistern.Clinical and radiological relief were followed after operation as well as discharge.Results A case of Mega cisterna magna was misdiagnosed as arachnoid cysts.Quadrigeminal cistern fenestration was manipulated in 6 cases,supracerebellar cistern fenestration in the other.Average period for follow - up was 14.5 months,88% ( 23/26 ) of cases was relieved symptomatically,92% (24/26) reverted to negative Romberg sign,and 8% (2/26) deflated in cyst volume.Meanwhile four cases of obstructive hydrocephualus were normal in ventriclar shapes after third ventriculotomy treatment.Conclusions CSF- orientated fenestration for arachnoid cysts in cisterua magna has shown promising effects clinically.As a result,physiological pattern of CSF - circulation should be restored primarily for it.

  • [1]Siehert JR.A pathological approach to anomalies of the poosterior fossa.Birth Defects Res A Clin Mol Teratol,2006,76:674-684.
  • [2]Gangemi M,Seneca V,Colella G,et al.Endoscopy versus mitcr-osurgical cyst excision and shunting for treating intracranial arachnoid cysts.J Neurosurg Pediatr,2011,8:158-164.
  • [3]Galarza M,López-Guerrero AL,Martínez-Lage JF.Posterior fossa arachnoid cysts and cerebellar tonsillar descent:short review.Neurosurg Rev,2010,33:305-314.
  • [4]鲁军体,汤祥军,涂汉军.枕大池蛛网膜囊肿研究进展.郧阳医学院学报,2008,27:186-189.
  • [5]楚功仁,史锡文,任立红,等.巨大枕大池25例分析中华神经外科杂志,1999,15:178-180.
  • [6]Steczkowska M,Slawomir K,Gergont A,et al.Arachnoid cysts and epilepsy in children.Przegl Lek,2010,67:1140-1144.
  • [7]Martínez-Lage JF,Pérez-Espejo MA,Almagro M J.et al.Hydrocephalus and arachnoid cysts. Childs Nerv Syst,2011,27:1643-1652.
  • [8]Robinson A J,Goldstein R.The cisterna magna sepia:vestigial remnants of Blake's pouch and a potential new marker for normal development of the rhombencephalon.J Ultrasound Med,2007,26:83-95.
  • [9]胡志强,朱广通,黄辉,等.脑脊液循环通路上囊肿导致梗阻性脑积水的内镜治疗.中华医学杂志,2009,89:1179-1184.
  • [10]Martínez-Lage JF,pérez-Espejo MA,Almagro MJ,et al.Hydrocephalus and arachnoid cysts.Childs Nerb Syst,2011,27:1643-1652.
  • [11]宗绪毅,李储忠,姜之全,等.颅内蛛网膜囊肿的治疗策略.中华神经外科杂志,2011,27:220-223.
  • [12]李新钢,王东海,徐淑军,等.非交通性蛛网膜囊肿的诊断与神经内镜治疗中华神经外科杂志,2005,21:91-94.
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