SURGICAL AND NONSURGICAL INTERVENTIONS OF ARACHNOIDS CYSTS (HOSPITAL EXPERIMENT WITH 32 CASES AND LITERATURE REVIEW)

Based on our limited data about pathophysiologic mechanisms and natural course of arachnoids cysts, surgical indications and nonsurgical interventions still remain controversial. Of course today literature favours endoscopic interventions for this pathology. In this study we retrospectively reviewed 32 cases managed in our neurosurgical ward over 5-years period. After treatment, patients were evaluated clinically and radiologically. Supratentorial cysts were seen in 69% (22 cases) while infratentorial cysts were seen in 31% (10 cases). Hemiparesis in 37%, increased intracranial pressure in 31%, seizure in 31%, macrocephaly in 19%, isolated headache in 6%, developmental delay in 6% and asymptomatic cysts were noted in 12% of cases. 24 cases (75%) were operated, cyst resection was done in10 cases and cystoperitoneal shunting in14 cases. Conservative treatment with regular clinical and imaging control was done in 25% of patients. The mean follow-up period has been 25 months (4 to 38 months). Good outcome was seen in 75% (18 cases) and 25% (6 cases) remained unchanged. With cyst resection the size of 6 cysts became small, two cases disappeared completely and with shunt 10 cases showed improvement. According to this study we could say that surgical intervention of symptomatic arachnoid cysts providing good results.