Article
Neuroendoscopic approach to ependymal cysts
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Authors
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Ahmed El Damaty
- Department of Neurosurgery, Heidelberg University, Heidelberg, Deutschland
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Sascha Marx
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Steffen Fleck
- Universitätsmedizin Greifswald , Klinik und Poliklinik für Neurochirurgie , Greifswald, Deutschland
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Henry W. S. Schroeder
- Ernst-Moritz-Arndt-Universität Greifswald, Klinik und Poliklinik für Neurochirurgie, Greifswald, Deutschland
| Published: | June 9, 2017 |
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Outline
Text
Objective: We aimed in our study to evaluate the success rate of endoscopic fenestration of intracranial ependymal cysts.
Methods: Our prospectively maintained endoscopy database was screened for all cases of ependymal cysts. The charts were retrospectively reviewed regarding symptoms, surgery, postoperative course, and complications. The MR images prior to and after surgery were analyzed.
Results: Seven patients harboring an intracranial ependymal cyst were identified. The cyst location was frontoparietal, parietal, occipital or mesencephalic. Patients presented with several symptoms according to the location of the cyst, i.e. epilepsy, hemiparesis, diplopia, and hemianopsia. All patients were treated by navigation-guided endoscopic fenestration of the cyst to the ventricular system. Two complications occurred; a CSF leakage which was managed surgically by wound revision without the need for CSF shunting and a chronic subdural hematoma occurred six weeks after surgery and required burr hole evacuation. The follow up period ranged from 6 months to 9 years. MR imaging revealed that all cysts decreased in size. The symptoms improved in all patients.
Conclusion: Endoscopic fenestration of ependymal cysts to an adjacent ventricular cavity is a very successful treatment option with excellent long-term results and minimal morbidity. It should be considered as the therapy of choice to avoid craniotomy and shunt dependence.
