Abstract
During the period from 1985 to 1992 we treated 43 patients with intracranial arachnoid cysts (ACs). In this retrospective study we assessed the outcome of these patients with regard to non-specific symptoms such as headaches and epileptic seizures. Twelve patients had headaches of obscure origin and a mostly temporal located AC. Six of these 12 underwent surgery. After the operation 4 patients (4/6) had no further headaches, two remained unchanged. The other 6 conservatively treated patients (6/12) had further headaches.
Ten of the 43 patients had epileptic seizures. One patient dropped out of the survey. Six of the 9 remaining patients had a temporal AC. Four of these 6 underwent surgery; postoperatively the seizure disease of 3 patients (3/6) declined. One patient was unchanged. Two patients with epileptic seizures and a temporal AC did not undergo surgery and both improved. Three patients with seizures had a convex located AC. Two of these 3 underwent surgery. The first patient improved postoperatively, the second patient remained unchanged. There was a reduction in the seizures of the medically treated patient.
It remains ambiguous, whether there is a relationship between epileptic seizures and intracranial ACs without obvious intracranial pressure signs. A review of the literature, however, showed mostly positive results concerning the surgical treatment of ACs under conditions of simultaneous epileptic seizures. However, the results largely depend upon the definition of the decline of the seizures with regard to the postoperative follow-up, therefore we must remain skeptical. Therapy guidelines in the future not only depend on the clarification of the pathophysiology of the ACs, but also on a reasonable outcome examination.
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References
Adams JH, LW Duchen (eds.): Malformations of the nervous system. Arachnoid cysts. In: Greenfield's Neuropathology, 5th edition, Edward Arnold Publications, London 1992
Aicardi J, F Bauman: Supratentorial extracerebral cysts in infants and children. J Neurol Neurosurg Psychiatry 38 (1975) 57–68
Anderson FM, HD Segall, WC Caton: Use of computerized tomography scanning in supratentorial arachnoid cysts. J Neurosurg 50 (1979) 333–338
Behrens P, CB Ostertag: Zystische Fehlbildungen des Gehirns: Stereotaktische Diagnostik und Therapie. Nervenarzt 63 (1992) 725–730
Bhandari YS: Non-communicating supratentorial subarachnoid cysts. J Neurol Neurosurg Psychiatry 35 (1972) 763–770
Bright R: Diseases of the brain and nervous system, part I. Reports of medical cases. Selected with a view of illustrating the symptoms and cure of diseases by a reference to morbid anatomy, vol 12; London: Longman, Rees, Orme, Brown, Green, Paternoster-Row and High ley, 1831
Christian W (ed.): Klinische Elektroenzephalographie, 3. Auflage, Georg Thieme, Stuttgart-New York 1982
Cilluffo JM BM Onofrio, RH Miller: The diagnosis and surgical treatment of intracranial arachnoid cysts. Acta Neurochirurgica 67 (1983) 215–229
Dei-Anang K, D Voth: Cerebral arachnoid cyst: a lesion of the child's brain. Neurosurg Rev 12 (1989) 59–62
Dyck P, P Gruskin: Supratentorial arachnoid cysts in adults. Arch Neurol 34 (1977) 276–279
Galassi E, F Fognetti, G Gaist, L Fagioli, F Frank, G Frank: CT Scan and Metrizamide CT Cisternography in Arachnoid Cysts of the Middle Cranial Fossa: Classification and pathophysiological Aspects. Surg Neurol 17 (1982) 363–369
Galassi E, G Gaist, G Giuliani, E Pozzati: Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically. Acta Neurochirurgica Suppl 42 (1988) 201–204
Gandy SE, LA Heier: Clinical and magnetic resonance features of primary intracranial arachnoid cysts. Ann Neurol 21 (1987) 342–348
Garcia-Bach M, F Isamat, F Vila: Intracranial arachnoid cysts in adults. Acta Neurochirurgica Suppl 42 (1988) 205–209
Geissinger JD, WC Kohler, BW Robinson, FM Davis: Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol Vol 10 (1978) 27–33
Giroud M, JL Sautreaux, A Thierry, R Dumas: Diencephalic epilepsy with congenital suprasellar arachnoid cyst in an infant. Child's Nerv Syst 4 (1988) 252–254
Go KG, HJ Houthoff, EH Blaauw, P Havinga, J Hartsuiker: Arachnoid cysts of the Sylvian fissure. Evidence of fluid secretion. J Neurosurg 60 (1984) 803–813
Harsh IV GR, MSB Edwards, CB Wilson: Intracranial arachnoid cysts in children. J Neurosurg 64 (1986) 835–842
Jelsma F, PJ Ross: Traumatic intracranial arachnoid cyst involving the Gasserian ganglion. Case report. J Neurosurg 26 (1967) 439–441
Kaplan BJ, JP Mickle, R Parkhurst: Cystoperitoneal shunting for congenital arachnoid cysts. Child's Brain 11 (1984) 304–311
Krawchenko J, G Collins: Pathology of an arachnoid cyst. Case Report. J Neurosurg 50 (1979) 224–228
Lange M, R Oeckler: Results of surgical treatment in patients with arachnoid cysts. Acta Neurochir (Wien) 87 (1987) 99–104
Locatelli D, N Bonfanti, R Sfogliarini, TM Gajno, S Pezzotta: Arachnoid cysts. diagnosis and treatment. Child's Nerv Syst 3 (1987) 121–124
Lüders HO (ed): Epilepsysurgery, Raven Press, New York 1992
Marinov M, S Undjian, P Wetzka: An evaluation of the surgical treatment of intracranial arachnoid cysts in children. Child's Nerv Syst 5 (1989) 177–183
Menezes AH, WE Bell, GE Perret: Arachnoid cysts in children. Arch Neurol 37 (1980) 168–172
Penfield W: Diencephalic epilepsy. Arch Neurol Psychiatry 22 (1929) 358–374
Quesney LF: Extratemporal epilepsy: Clinical presentation, pre-operative EEG localization and surgical outcome. Acta Neurol Scand Vol 86 (Suppl 140) (1992) 81–94
Raffel C, JG McComb: To shunt or to fenestrate: Which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery 23 (1988) 338–342
Robinson RG: Congenital cysts of the brain: arachnoid malformations. Prog Neurol Surg 4 (1971) 133–174
Ruscalleda J, E Guardia, FM Santos, A Carvajal: Dynamic Study of Arachnoid Cysts with Metrizamide. Neuroradiology 20 (1980) 185–189
Sharma SC, RC Ray: Middle fossa arachnoid cysts. Indian Pediatrics 26 (July) (1984) 720–723
Shaw CM, EC Alvord: Congenital arachnoid cysts and their differential diagnosis. In: Vinken PJ, GW Bruyn: Handbook of Clinical Neurology, Vol 31. New York, Elsevier 1977
Smith RA, WA Smith: Arachnoid cysts of the middle cranial fossa. Surg Neurol 5 (1976) 246–252
Sprung C, W Mauersberger: Value of computed tomography for the diagnosis of arachnoid cysts and assessment of surgical treatment. Acta Neurochirurgica Suppl 28 (1979) 619–626
Stein SC: Intracranial development of cysts in children: treatment by cystoperitoneal shunting Neurosurgery 8 (1981) 647–650
Van der Meche FGA, R Braakman: Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms. J Neurol Neurosurg Psychiatry 46 (1983) 1102–1107
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Koch, C.A., Voth, D., Kraemer, G. et al. Arachnoid cysts: does surgery improve epileptic seizures and headaches?. Neurosurg. Rev. 18, 173–181 (1995). https://doi.org/10.1007/BF00383722
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DOI: https://doi.org/10.1007/BF00383722