• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.69-73
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• 2006

Objective : The optimal surgical treatment for symptomatic middle cranial fossa arachnoid cysts is controversial. Therapeutic options include endoscopic fenestration, excision, cyst shunting, and craniotomy for fenestration of basal cistern. We reviewed the results of surgically treated middle cranial fossa arachnoid cysts. Methods : We performed a retrospective study in 18 cases of middle cranial fossa arachnoid cysts who had been treated with microsurgical fenestration between 1995 to 2003. The analysis was based on the results of the patients' age, sex distribution, developed area, clinical symptoms, treatment method, and complications. Results : Eighteen surgical treated middle cranial fossa arachnoid cysts patients were evaluated. The age range of cyst development was between 2 years and 44 years with the average of 16.4 years. The follow-up periods averaged 31.48 months. There were 15 male and 3 female patients, with significantly more cyst development in males than females. The most common clinical symptom was headache, followed by seizure. In the entire series, 77.8% of patients demonstrated a decrease in cyst size In serial imaging studies. Of them, 67.3% demonstrated a complete cyst effacement. Overall, 100% of patients with Grade I cysts, 81.8% of patients with Grade II cysts, 60% of patients with Grade III cysts exhibited evidence of decrease in cyst size during long-term monitoring. Complications included headache, meningitis, and hydrocephalus. Conclusion : Patients who were treated with microsurgical fenestration showed good outcome with acceptable complications. We concluded that microsurgical fenestration is a safe and effective surgical method for middle cranial fossa arachnoid cysts.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.314-318
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• 2016

Posterior fossa is a site next to the middle fossa where arachnoid cyst frequently occurs. Generally, most arachnoid cysts are asymptomatic and are found incidentally in most cases. Although arachnoid cysts are benign and asymptomatic lesions, patients with posterior fossa arachnoid cysts often complain of headaches, gait disturbance, and ataxia due to the local mass effects on the cerebellum. We observed a patient with a posterior fossa arachnoid cyst who had visual symptoms and a headache, but did not have gait disturbance and ataxia. We recommended an emergency operation for decompression, but the patient refused for personal reasons. After 7 days, the patient revisited our hospital in a state of near-blindness. We suspected that the arachnoid cyst induced the hydrocephalus and thereby the enlarged third ventricle directly compressed optic nerves. Compressed optic nerves were rapidly aggravated during the critical seven days; consequently, the patient's vision was damaged despite the operation. Considering the results of our case, it is important to keep in mind that the aggravation of symptoms cannot be predicted; therefore, symptomatic arachnoid cysts should be treated without undue delay.

• Investigative Magnetic Resonance Imaging
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• v.25 no.1
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• pp.43-46
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• 2021

Arachnoid cysts are benign lesions that are formed between the inner and outer layers of the arachnoid, accounting for 1% of all intracranial space occupying lesions. Usually, arachnoid cysts are asymptomatic. It can be symptomatic in case of complication such as intracystic hemorrhage or acute cyst expansion. We present a case of incidentally prediagnosed arachnoid cyst which undergone intracystic hemorrhage combined with ipsilateral SDH in a young male.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.340-343
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• 2001

Arachnoid cysts are defined as duplicated arachnoids and their splitting with congenital, intra-arachnoid, and leptomeningeal malformations. They are most commonly located in the middle cranial fossa followed by suprasellar and quadrigeminal cisterns, posterior fossa, and very rare in cerebral convexities. They are often ruptured by trauma or spontaneously and cause subdural hygroma or subdural hematoma. Authors report a case of a 32-year-old woman with a convexity arachnoid cyst mimicking subdural hygroma associated with a separate middle fossa arachnoid cyst. Preoperatively, the convexity arachnoid cyst was misinterpreted as subdural hygroma resulted from a ruptured middle fossa cyst. The patient underwent craniotomy and cyst fenestration into the basal cistern. Two separate arachnoid cysts were found in the cerebral convexity and middle cranial fossa during the operation. Finally, cysts were resolved and she was discharged without any complication.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.366-370
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• 2006

Arachnoid cysts are intra-arachnoid collections of cerebrospinal fluid. They may cause neurological deficit through expansion that can compress normal neural tissue and obstruct cerebrospinal fluid flow. Intracranial arachnoid cysts were found in 4 patients aged 10 months to 20 months(mean age 15 months). The presenting symptoms included circling(dog 2,3), seizure(dog 1), progressive weakness(dog 1,2,3), increasing scoliosis(dog 3), worsening spasticity(dog 3), and salivation(dog 3). One patient showed no symptoms from the intracranial arachnoid cyst. There were no significant findings in complete blood count and serum chemistry. Computed tomography(CT) with/without magnetic resonance imaging(MRI) scans were performed in these cases. Hypodense intracranial arachnoid cyst was observed on CT images in dog 4. Sagittal T1-weighted(T1W) and T2-weighted(T2W) images and transverse T1W and T2W images revealed a intracranial arachnoid cysts with syringohydromyelia(dog 3) and hydrocephalus(dog 3,4) in the brain. Clinical signs of three cases were improved by medication.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.928-933
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• 2001

Intraventricular arachnoid cyst has been rarely reported. Here we present two cases of symptomatic intraventricular arachnoid cysts in the fourth ventricle and right lateral ventricle. The first patient was a 38-year-old female who complained of headache and left facial hypesthesia. Computed tomography and MR scan revealed large cystic lesion in the fourth ventricle. After cyst wall removal, facial hypesthesia disappeared immediately and headache improved slowly. The second patient was a 9-year-old girl who complained of headache, vomiting and paresthesia in her right low extremity. Cystic lesion in the right lateral ventricle was detected in the CT and MR scan. The symptoms improved after cyst wall removal. Surgical findings of these two cases showed that the cyst walls were attached firmly to the choroid plexus. Symptomatic intraventricular arachnoid cyst must be treated appropriately and we recommend complete cyst wall removal.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.160-164
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• 2008

A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.257-260
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• 2012

Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.433-436
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• 2010

Objective : Arachnoid cysts (ACs) can be cured by making the definite and wide communication between the cyst and arachnoid space using endoscopy, but often it is impossible only through the usual working-channel (intra-channel) procedures. We discuss and propose a more valuable endoscopic technique with the presentation of our series of cases. Methods : We treated 9 patients with cortical AC in various locations with extra-channel endoscopic techniques. The patients ranged in age from 3 years to 60 years (mean age, 37.2 yrs). The follow-up period ranged from 12 to 26 months (mean follow-up duration, 17.2 months). All patients had large AC compressing the adjacent brain with clinical symptoms or signs. The authors performed extensive fenestration via single burr hole with the aid of endoscope. Being bypassed the rigid endoscope, through the space between the shaft of endoscope and guiding cannula (extra-channel method), fenestration procedures were done in the dry fields. Results : Eight (88.9%) patients had been treated successfully with endoscope. One patient required shunt procedure. Among the eight patients who were treated with endoscopic procedure, 6 patients (66.7%) showed cyst reduction, and two (22.2%) showed disappearance of cyst. Conclusion : We suggest that extra-channel method will be simple and easy to perform using more valuable instruments with wider working area, and may promise better results compared to the conventional intra-channel endoscopic procedures.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.262-266
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• 2011

Objective : The endocrine dysfunction after the operation for suprasellar arachnoid cysts is not rare. The careful operation to prevent structures can prevent this complication, but it is not enough and effective to prevent it. Authors present technical surgical considerations to prevent this complication with a review of our suprasellar arachnoid cyst patients who had postoperative endocrine dysfunction. Methods : From January 2002 to December 2009, eight patients who had suprasellar arachnoid cysts with visual impairment underwent surgery. The mean age was 57.1 years (range, 33-77). Preoperatively, their endocrine function was clinically normal, and laboratory hormonal levels were within normal ranges. Cyst fenestration was performed by craniotomy (n=6) or by a neuro-endoscopic procedure (n=2), and, simultaneously, along with a cyst wall biopsy. Results : The surgery was uneventful in all eight patients, and there were no neurological morbidities. However, in four patients, endocrine dysfunction occurred postoperatively. We compared these four patients (group A) to the other 4 patients without endocrine dysfunction (group B) with intraoperative findings and with the histopathological findings of the cyst wall biopsy. The group A patients had more abundant vasculature on the cystic wall than the group B patients according to both the intraoperative findings and the histopathological findings. Conclusion : When performing a surgical cyst wall fenestration, surgeons should try to minimize the destruction of the cystic wall vasculature and not to make the fenestration at a site that contains many vascular striae.