gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Frame-based stereotactic cysto-ventricular shunt implantation for treatment of acquired intracerebral cysts

Rahmenbasierte stereotaktisch geführte Implantation von zysto-ventrikulären Shunts zur Behandlung erworbener intrazerebraler Zysten

Meeting Abstract

  • presenting/speaker Anna-Katharina Meißner - University Hospital Cologne, University of Cologne, Department of General Neurosurgery, Köln, Deutschland; University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Köln, Deutschland
  • Lena Dreher - University Hospital Cologne, University of Cologne, Department of General Neurosurgery, Köln, Deutschland
  • Veerle Visser-Vandewalle - University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Köln, Deutschland
  • Maximilian I. Ruge - University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Köln, Deutschland; Universities of Aachen, Bonn, Cologne and Düsseldorf, Center for Integrated Oncology (CIO), Köln, Deutschland
  • Daniel Rueß - University Hospital Cologne, University of Cologne, Department of Stereotactic and Functional Neurosurgery, Köln, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP132

doi: 10.3205/21dgnc420, urn:nbn:de:0183-21dgnc4204

Veröffentlicht: 4. Juni 2021

© 2021 Meißner et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The treatment of symptomatic, progressive or recurrent acquired intracerebral cysts is challenging especially when localized in eloquent or deep-seated midline structures. Hereby, the frame-based stereotactic implantation of cysto-ventricular shunts offers a minimally invasive and highly precise technique. Here we evaluated the feasibility and efficacy of this technique in patients with acquired intracerebral cysts of different origins.

Methods: In this single center retrospective analysis, we included all patients with acquired intracerebral cysts who underwent frame-based stereotactically guided internal cysto-ventricular shunt implantation between 2012 and 2020. Patient data were analyzed in terms of clinical symptom control, unexpected side effects and radiological outcome concerning cyst volume reduction (3D volumetry).

Results: Thirty-five patients (f/m =18/17, median age 43 years, range 2-77 years) were identified. Median cyst volume before treatment was 11.6 cm3 (range 1.6-71.6 cm3) and mean follow-up was 21 months (range 0-82 months). At last follow-up, a mean reduction of cyst volume of 73.3% could be achieved. Initial symptoms improved or were completely regressive in 49% of cases (n=17) and remained stable in 40% (n=14). No permanent clinical deterioration after treatment was observed. Three patients required surgical catheter revision due to shunt obstruction or infection.

Conclusion: In our analysis, stereotactic internal cysto-ventricular shunting proves to be a safe and effective surgical method with excellent long-term control of cyst volume, clinical improvement and a lack of severe permanent side effects. Therefore, this technique offers an alternative to endoscopic or microsurgical approaches as a first-line treatment in patients with acquired intracerebral cysts of different entities.