gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Treatment of arachnoidal cysts with endoscopic fenestration and shunting with programmable valve: our experience

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  • C. Mottolese - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
  • corresponding author A. Szathmari - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
  • A. C. Ricci - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
  • C. Ginguené - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
  • C. Lak - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
  • B. Vallée - Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-01.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0001.shtml

Published: May 4, 2005

© 2005 Mottolese et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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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.