Intracranial extradural arachnoid cyst in a child

Effect comparison of neuroendoscopic vs. craniotomy in the treatment of adult intracranial arachnoid cyst

Purpose

Intracranial arachnoid cysts are common, accounting for about 1%-2% of intracranial space-occupying lesions. There is controversy over the method of surgical intervention, and in order to provide guidance for surgical decision making, this study compares the efficacy of craniotomy vs. neuroendoscopic surgery in treating arachnoid cysts.

Methods

The adult patients with arachnoid cyst admitted to our department from October 2016 to August 2021 were retrospectively analyzed. Thirteen adult patients were recruited, and divided into two groups: neuroendoscopic group (group A) and craniotomy group (group B). We compared the gender, age, clinical symptoms, preoperative and postoperative cyst sizes, symptom improvement, complications, length of hospital stay, and hospital costs between two groups to analyze the therapeutic effects of these two surgical methods.

Results

The cost of hospitalization in group A was significantly lower than that in group B (47,292.8 vs. 65,151.8 yuan, P < 0.05), and there was no difference in the length of hospital stay between the two groups. The preoperative cysts in group A were significantly larger than those in group B (6.38 vs. 2.97 cm, P < 0.05). In groups A and B, the short-term symptom improvement rates were 100% and 75.0%, respectively. The long-term symptom improvement rates were 77.78% and 75.0% (P > 0.05), respectively.

Conclusion

Both neuroendoscopic and craniotomy have good curative effects for the treatment of intracranial arachnoid cysts. There was no significant difference in the outcomes between the two surgical techniques. The cost of hospitalization can be reduced with neuroendoscopic surgery. Neuroendoscopic treatment is recommended for large intracranial arachnoid cysts, and craniotomy is suitable for small intracranial arachnoid cysts.

Fluid-Filled Dehiscences in the Anterior Cranial Fossa Floor: A Magnetic Resonance Imaging Study

OBJECTIVE

To date, only limited information regarding the anterior cranial fossa floor (AFF) and the appearance of sites of dehiscence and potential channels has been available. We aimed to evaluate this region with thin section magnetic resonance imaging (MRI).

PATIENTS AND METHODS

A total of 65 patients underwent thin-sliced coronal T2-weighted MRI. The AFF was divided into 3 parts for analysis: the anterior, middle, and posterior.

RESULTS

Dehiscences were identified in 84.6% of 65 patients with apparently transmitting channels. In 49.2% of the patients, the dehiscences were located in the anterior part, whereas they were located in the middle and posterior parts in 52.3% and 12.3%, respectively. The morphology and number of these dehiscences were highly variable. In 12.3%, channels in the dehiscences were distributed extradural. Statistically, dehiscences were more frequently identified on the left side in any part of the AFF.

CONCLUSIONS

With thin-sliced, coronal T2-weighted MRI, dehiscences were frequently identified in the anterior two-thirds of the AFF. Further study is warranted to determine the role of AFF channels and dehiscences, including possibly for cerebrospinal fluid drainage.

Multiple extradural spinal arachnoid cysts: A case report

Background:

Extradural spinal arachnoid cysts (SACs) rarely cause neural compression and disability.

Case Description:

A 38-year-old female presented with a history of two episodes of falling due to transient weakness in the lower limbs. The neurological examination showed normal motor and sensory function, but hyperreflexia. The thoracic magnetic resonance imaging revealed multiple extradural SACs between the T3-L1 levels. Following complete surgical resection of the most symptomatic cyst, she did well. The histopathological examination confirmed a Type I extradural SAC.

Conclusion:

Here, we discussed one case and reviewed the literature on the diagnosis and treatment of multiple extradural SACs.