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Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series
INTRODUCTION AND AIM: The management of posterior fossa arachnoid cyst (PFAC) in adults is controversial. To review our cases and literature, propose a practically useful surgical strategy, which gives excellent long-term outcome in management of PFAC. MATERIALS AND METHODS: We analyzed our case rec...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352631/ https://www.ncbi.nlm.nih.gov/pubmed/25767579 http://dx.doi.org/10.4103/1793-5482.151512 |
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author | Srinivasan, Uddanapalli Sreeramulu Lawrence, Radhi |
author_facet | Srinivasan, Uddanapalli Sreeramulu Lawrence, Radhi |
author_sort | Srinivasan, Uddanapalli Sreeramulu |
collection | PubMed |
description | INTRODUCTION AND AIM: The management of posterior fossa arachnoid cyst (PFAC) in adults is controversial. To review our cases and literature, propose a practically useful surgical strategy, which gives excellent long-term outcome in management of PFAC. MATERIALS AND METHODS: We analyzed our case records of 26 large intracranial arachnoid cysts in adults treated over 12 years. Of them, we had 7 patients with symptomatic PFAC. Reviewed the literature of 174 PFAC cases (1973–2012) and added 7 of our new cases with a follow-up ranging from 3 to 12 years. RESULTS: In 6 cases the PFAC was located in the midline. In the 7(th) case, it was located laterally in the cerebello-pontine (CP) angle. All patients were treated surgically. Excision of the cyst was performed in 5 of these cases. Among the two intra-fourth ventricular cysts, in both the cases cysto-peritoneal shunt was performed. Postoperative computed tomography/magnetic resonance imaging showed variable decrease in size of the cyst even though clinically all patients improved. We propose a surgical strategy for the management of these cases which would aid the surgeon in decision making. DISCUSSION: We observed that these PFACs can occur either in the midline within the fourth ventricle or retroclival region or extra-fourth ventricular region. It can also develop laterally in the CP angle or behind the cerebellum or as intracerebellar cyst. Importance of this is except for Midline Intra-fourth ventricular cyst/retroclival cyst, the rest all can be safely excised with excellent long term outcome. The treatment strategy for Midline Intra-fourth ventricular cyst/retroclival cyst can be either cysto-peritoneal shunt or endoscopic fenestration of the cyst. |
format | Online Article Text |
id | pubmed-4352631 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-43526312015-03-12 Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series Srinivasan, Uddanapalli Sreeramulu Lawrence, Radhi Asian J Neurosurg Original Article INTRODUCTION AND AIM: The management of posterior fossa arachnoid cyst (PFAC) in adults is controversial. To review our cases and literature, propose a practically useful surgical strategy, which gives excellent long-term outcome in management of PFAC. MATERIALS AND METHODS: We analyzed our case records of 26 large intracranial arachnoid cysts in adults treated over 12 years. Of them, we had 7 patients with symptomatic PFAC. Reviewed the literature of 174 PFAC cases (1973–2012) and added 7 of our new cases with a follow-up ranging from 3 to 12 years. RESULTS: In 6 cases the PFAC was located in the midline. In the 7(th) case, it was located laterally in the cerebello-pontine (CP) angle. All patients were treated surgically. Excision of the cyst was performed in 5 of these cases. Among the two intra-fourth ventricular cysts, in both the cases cysto-peritoneal shunt was performed. Postoperative computed tomography/magnetic resonance imaging showed variable decrease in size of the cyst even though clinically all patients improved. We propose a surgical strategy for the management of these cases which would aid the surgeon in decision making. DISCUSSION: We observed that these PFACs can occur either in the midline within the fourth ventricle or retroclival region or extra-fourth ventricular region. It can also develop laterally in the CP angle or behind the cerebellum or as intracerebellar cyst. Importance of this is except for Midline Intra-fourth ventricular cyst/retroclival cyst, the rest all can be safely excised with excellent long term outcome. The treatment strategy for Midline Intra-fourth ventricular cyst/retroclival cyst can be either cysto-peritoneal shunt or endoscopic fenestration of the cyst. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4352631/ /pubmed/25767579 http://dx.doi.org/10.4103/1793-5482.151512 Text en Copyright: © Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Srinivasan, Uddanapalli Sreeramulu Lawrence, Radhi Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title | Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title_full | Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title_fullStr | Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title_full_unstemmed | Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title_short | Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series |
title_sort | posterior fossa arachnoid cysts in adults: surgical strategy: case series |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352631/ https://www.ncbi.nlm.nih.gov/pubmed/25767579 http://dx.doi.org/10.4103/1793-5482.151512 |
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