Artikel
Treatment of arachnoidal cysts with endoscopic fenestration and shunting with programmable valve: our experience
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
Text
Methods
Out of 89 patients with arachnoidal cyst observed from 1982, 28 were treated from 1996 to 2002. Twenty patients have been treated with endoscopic fenestration associated in the same time with a shunt using a programmable valve. In 18 cases the location was temporo-sylvian, in 3 cases opto-chiasmatic and 3 cases in the lateral posterior fossa. All patients have been followed with MRI or CT-scan in the follow up yearly. The follow up varies from 5 years to 1 year. No haemorrhagic or infectious complications were reported.
Results
All patients presented a clinical improvement concerning intracranial hypertension. From radiological point of view we have observed the complete disappearance of the cyst in 13 cases (11 in the temporo-sylvian location), and a decrease in the other 11 cases. In 12 patients after the progressive increase of the opening pressure of the valve it was possible to suppress it thereafter. In the others cases that are regularly followed we are increasing the opening pressure of the shunt according to the reduction of the size of the cyst.
Conclusions
Our experience shows that the endoscopic fenestration of arachnoidal cyst in the same time with a programmable shunt favours:
- the disappearance of the cyst
- the decrease of the shunt dependency, allowing the removal of the shunt in 50% of patients.
The complications rates of two associated techniques in our experience were very low.