Posterior fossa arachnoid cysts in adults: Surgical strategy: Case series

Asian Journal of Neurosurgery
Uddanapalli Sreeramulu Srinivasan, Radhi Lawrence

Abstract

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. 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. 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. We observed that these PFACs can occur either in the midline within the fourth ventricle or retroclival region or extra-fourth ventricular region...Continue Reading

Citations

Oct 30, 2021·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·K V ShevchenkoV K Poshataev

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