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

Mesencephalic ependymal cysts: surgical technique and clinical outcome

Ependymale Zysten des Mesencephalon: operative Strategie und klinisches Ergebnis

Meeting Abstract

  • corresponding author J. Conrad - Abteilung für Neurochirurgie, Universitätsklinikum Mainz
  • S. Welschehold - Abteilung für Neurochirurgie, Universitätsklinikum Mainz
  • C. Charalampaki - Abteilung für Neurochirurgie, Universitätsklinikum Mainz
  • A. Perneczky - Abteilung für Neurochirurgie, Universitätsklinikum Mainz

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. DocP213

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0481.shtml

Published: May 4, 2005

© 2005 Conrad 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

Text

Objective

Ependymal or epithelium-lined cysts of the mesencephalon are rare lesions that usually occur with symptoms of an occlusive hydrocephalus or symptoms like Parinaud's syndrome, dizziness or long tract symptoms. The objective of this retrospective study is an evaluation of the surgical technique for the treatment of these cysts and the clinical outcome of the patients.

Methods

The clinical records of eight patients treated for symptomatic mesencephalic ependymal cysts in the last ten years in our department were studied retrospectively. The patient age ranged from 22 to 60 years with a mean age of 44 years. The group consisted of seven women and one man. Four patients had been operated on using a suboccipital infratentorial supracerebellar approach in an endoscope-assisted microsurgical technique, the other four patients underwent a purely endoscopic procedure over a frontal burr hole trepanation. The keyhole concept was applicable to both techniques.

Results

In all of the patients, an adequate fenestration of the cyst was achieved. Four patients were symptom-free, the other four improved significantly after a mean follow-up duration of 38.5 months (range 5 to 119 months). One patient underwent two operations: ventriculocystostomy and four months later an endoscopic third ventriculostomy because of recurrent hydrocephalus. In one case a second surgical procedure was necessary because of a wound infection. The patients were aböe tp leave the hospital during the first week after surgery.

Conclusions

Mesencephalic ependymal cysts can be treated successfully and most likely permanently by a purely endoscopic or endoscope-assisted keyhole neurosurgical technique. There was no morbidity or mortality related to these procedures in this group of eight patients. Because of these results, we regard the described surgical procedures to be a great alternative to treatments such as shunting (ventriculoperitoneal and -atrial, cystocisternal) or stereotactic aspiration of the cysts.