Title : Management Protocol and the Current State of Surgical Techniques for Adult Intracranial Arachnoid Cysts
Abstract:
Background:
Intracranial arachnoid cysts are collections of cerebrospinal fluid that are likely benign and asymptomatic. A subset of patients go on to have neurosurgical intervention. The imaging and clinical presentation findings should guide surgical decision making in a standardized manner.
Method:
A literature review was conducted searching the Medline database with MESH terms. This literature was condensed into an article, edited by a consultant Neurosurgeon. This was further condensed, presented to the Neurosurgery department at Princess Alexandra Hospital for final feedback and editing.
Results:
A protocol for managing cysts was developed, the most important factor being symptomatology. Asymptomatic patients with typical cysts were recommended for reassurance. Symptomatic cysts or those with atypical features should be discussed with a neurosurgical service for consideration of intervention. The current evidence for surgical techniques is compared, In general, current evidence suggests that the treatment of symptomatic arachnoid cysts with surgical intervention does appear effective. Superiority is not demonstrated on a general basis for techniques, but anatomical considerations and cyst location can guide operative planning.
Discussion:
Recognising the small number of symptomatic patients and those with cysts in areas sensitive to causing hydrocephalus, correlating the presenting neurology is key to management. Craniotomy or endoscopic fenestration are viable options that can be considered on surgeon preference.
Keywords:
Intracranial Arachnoid Cyst, Adult Neurosurgery, Surgical Technique, Management Protocol
What will audience learn from your presentation?
- Improved Management decision making in an algorithmic fashion
- Understanding of the current state of literature comparing surgical techniques
Higher yield tertiary care for patients who may require intervention or follow up
