부산대학교 도서관

BACKGROUND Arachnoid cysts (ACs) are congenital, benign, non-neoplastic, extra axial lesions. MATERIALS AND METHODS The authors study 417 paediatric cases, admitted at the "Bagdasar- Arseni", January 2004-January 2019 (15 years). The location of all ACs involved: Sylvian fissure 224 cases (54%); CP angle 50 cases (12%); suprasellar 42 cases (10%); pineal 38 cases (9%); retrocerebelar 38 cases (9%); interhemisferic 25 cases (6%). Clinical finding: focal bulging of the skull 259 cases (62%); irritability 213 cases (51%); epilepsy 133 cases (32%); focal neurological symptoms 75 cases (18%); cranial nerves palsy 46 cases (11%); ICP syndrome 54 cases (13%). The major investigation - MRI, with all facilities, as it allows for a perfect diagnosis without having an invasive character. The treatment: simple observation 53 (12,6%), unishunt cystoperitoneal 214 (51,4%), low pressure valve cysto-peritoneal shunt 26 (6,3%), endoscopic procedures 40 (9,7%), 84 (20,1%) an open microsurgical approach with cyst fenestration. RESULTS The 53 cases of ACs which have remained in observation showed no modification in time. 214 cases which benefited from a unishunt cysto-peritonal showed an obvious shrinkage of the cyst in 189 cases at 3 years post-op (88.2%). Out of the 26 cases (6,3%) which benefited from a low pressure valve a number of 21 (80%) showed a favourable evolution at 3 years post op. From 40 cases who received endoscopic approach. 27 (67%) cases had cyst shrinkage at 3 years postop; two cases developed complications due to bleeding from venous plexes. Microsurgery alone (84 cases). Shrinkage was noticed only in 54 cases despite wide fenestration and opening of the arachnoid spaces. CONCLUSIONS ACs are congenital cerebral malformations with more than 80% of all cases being incidental findings. Treatment is recommended only in symptomatic ACs. MRI is gold standard in evaluation and followup. [ABSTRACT FROM AUTHOR]