Background and Aim: Intracranial Arachnoid Cysts (IAC) are suitable choices for endoscopic procedure to avoid craniotomy or shunt placement. Our main objective is to study the outcome of endoscopic procedure in IAC treatment. Methods and... more
Background and Aim: Intracranial Arachnoid Cysts (IAC) are suitable choices for endoscopic procedure to avoid craniotomy or shunt placement. Our main objective is to study the outcome of endoscopic procedure in IAC treatment. Methods and Materials/Patients: In this descriptive and retrospective study, we report our experience of 27 symptomatic patients with IAC who underwent endoscopic surgery at. The recorded data of patients' management including operations, outcomes, and follow up were studied retrospectively. The diagnosis was confirmed by neuroimaging, surgery and histopathological examination. Patients were postoperatively followed up on regular basis. Results: Size of the IAC decreased (significant to minimal) in all cases. Even where size reduction was minimal, patients' symptoms improved significantly. No IAC increased in size after endoscopic procedure. There was no recurrence of symptoms in the follow up period. There was no postoperative mortality or major morbidity related to the surgery. Conclusion: Based on our results, most of symptomatic IAC cases can be managed by endoscopic procedure which seems to be a safe and effective method. Citation: Hossain Chowdhury F, Raziul Haque M, Khaled Chowdhury N, Islam Khan Sh, Mohammod N. Endoscopic Surgical Management of Intracranial Symptomatic Arachnoid Cyst. Iran J Neurosurg. 2018; 4(2):61-74. http://dx.
Introduction: An arachnoid cyst in the internal auditory canal is a quite rare pathology but due to its compressive action on the nerves in this district should be surgically removed. Several surgical techniques have been proposed but no... more
Introduction: An arachnoid cyst in the internal auditory canal is a quite rare pathology but due to its compressive action on the nerves in this district should be surgically removed. Several surgical techniques have been proposed but no surgeons have used the minimally assisted endoscope retrosigmoid approach for its removal. Objective: To investigate the feasibility of using a minimally invasive endoscope assisted retro-sigmoid approach for surgical removal of arachnoid cysts in the internal auditory canal. Methods: Minimally invasive endoscope assisted retrosigmoid approach allows to access to the internal auditory canal through a minimally invasive retrosigmoid approach that combines the use of a microscope and an endoscope. It is performed in six steps: soft tissue step, bone step, dura step, cerebellopontine angle step (performed using an endoscope and a microscope), microscope-endoscope assisted arachnoid cysts removal and closure. We tested minimally inva-sive endoscope assisted retrosigmoid approach for removal of arachnoid cysts in the internal auditory canal on two human cadaveric heads (specimens) of subjects affected from audio-vestibular disorders and with arachnoid cysts in the internal auditory canal confirmed by magnetic resonance imaging. Results: The mass was completely and successfully removed from the two specimens with no damage to the nerves and/or vessels in the surgical area.
Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency... more
Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma.
Background and Importance: Arachnoid cysts are developmental cystic lesions which may be found as an incidental finding on neuroimaging or present with symptoms of headache, seizure and neurologic deficit. Presentation with seizure is... more
Background and Importance: Arachnoid cysts are developmental cystic lesions which may be found as an incidental finding on neuroimaging or present with symptoms of headache, seizure and neurologic deficit. Presentation with seizure is more common with larger sizes and temporal location. Presentation with Temporal Lobe Epilepsy (TLE) is rare, and fenestration of cysts has variable results for seizure control. We reported controlling TLE symptoms following endoscopic transsphenoidal fenestration of an arachnoid cyst. The anteromedial location in middle fossa, extension toward sphenoid sinus and normal appearance of mesial temporal structures on MRI encouraged us to consider this surgical approach. Case Presentation: A 26-year-old patient with a 13-year history of TLE with uncontrolled symptoms despite taking a combination of AEDs (LTG, CBZ, LEV, CLB) was referred to our clinic. Neuroimaging revealed an arachnoid cyst in anteromedial part of temporal fossa which extended to sphenoid sinus, but showed no abnormality in mesial temporal structures. Endoscopic endonasal transsphenoidal fenestration of the arachnoid cyst was performed, and followed by reconstruction of the skull base. The procedure improved the seizure control during the 9-month follow-up and no sign of radiologic recurrence was observed. Conclusion: Transsphenoidal endoscopic fenestration is a safe and feasible surgical approach for treatment of symptomatic arachnoid cysts in anteromedial part of middle fossa especially when they extend toward lateral wall of sphenoid sinus. This surgical corridor has the privilege of avoiding cortical injury accompanied by transcranial approaches, which is deleterious in epileptic patients.
Citation Di Stadio A. Arachnoid cyst of internal auditory canal: How the temporal bone findings explain ear symptoms and suggest the best treatment to do. ABSTRACT Objective: Aim of this short review is to identify relevant findings in... more
Citation Di Stadio A. Arachnoid cyst of internal auditory canal: How the temporal bone findings explain ear symptoms and suggest the best treatment to do. ABSTRACT Objective: Aim of this short review is to identify relevant findings in clinical and surgical treatment studying arachnoid cyst of internal auditory canal. Study design: Retrospective study of relevant papers in literature. Methods: PubMed and Google Scholar searches using the following keywords: arachnoid cyst, internal auditory canal, temporal bones study, schwannoma of internal auditory canal, cystic schwannoma, MRI findings, surgery of internal auditory canal. Only the article where three keywords, included always arachnoid cyst, were considered. The study analyzed the etiopatho-genesis of arachnoid cyst, hearing and vestibular symptoms and temporal bone findings. Review and conclusion: The author identified and reviewed a total of 46 articles. The results showed high incidence of hearing loss that was the more common symptom than vestibular one. Arachnoid cyst carried out more compression on the vestibular nerves than on the cochlear one. The review allowed us to identify which mechanism of damage arachnoid cyst acting on the nerves. It is necessary to consider the arachnoids cyst in differential diagnosis with tumors and pathologies involving the internal auditory canal.
