Endoscopic Treatment of Suprasellar Arachnoid Cysts

Abstract

Background: Endoscopic fenestration of suprasellar arachnoid cysts has become a popular way in their treatment. Here, we describe our experience and results about this concept in Shiraz.

Materials and Methods: This is a descriptive study on a series of patients with symptomatic suprasellar arachnoid cyst that had endoscopic ventriculocystocisternostomy by a single team in Shiraz between September 2008 and May 2013.All of them had at least 6 month post operative follow up with clinical and imaging assessments.

Results: There were 8 patients by the mean age of 8 years (Ranged 14 months to 24 years) including 3 females and 5 males. We had no operation related complications in our patients. Symptoms of high intracranial pressure were regressed in all patients including bulged fontanel, nausea and vomiting, etc. Four of them had ataxia in preoperative examination that was improved in two. One patient had complain of increase in headache intensity with no sign of high intracranial pressure and good imaging improvement. Seven patients had imaging improvement including regression of cyst size and hydrocephalus. One patient had concomitant C1- C2 instability due to kelippel- feil syndrome that was dismissed first. He came back with spastic quadriparesis 2 months after endoscopic operation and initial improvement of symptoms. He underwent C1-C2 fixation.

Conclusion: Endoscopic ventriculocystocisternostomy is a useful treatment for suprasellar arachnoid cysts with low operation related complications and good clinical and imaging results.

 Keywords: Suprasellar arachnoid cyst, Endoscopy, Ventriculocystocisternostomy