Treatment of symptomatic interhemispheric arachnoid cysts by cystoperitoneal shunting |
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| Authors: | Mustafa Onur Ulu Ali Metin Kafadar Reza Dashti Cihan İşler Seyfettin Uludağ Pamir Erdinçler |
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| Affiliation: | 1. Department of Neurosurgery, Sakarya Toyotasa State Hospital, Giseler Mevki Nehir Kent, Tem Uzeri Adapazar? Cikisi, Sakarya, Turkey;2. Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey;3. Department of Neurosurgery, Istanbul Ba?c?lar Education and Research Hospital, Istanbul, Turkey;4. Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey;1. Department of Radiology, Faculty of Medicine, Ataturk University, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum 25240, Turkey;2. Department of Orthopaedic Surgery, Faculty of Medicine, Ataturk University, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum 25240, Turkey;1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;2. Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA;4. Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA;3. Division of Neuro-ophthalmology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA;1. Institute of Nephrology, Department of Nephrology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China;2. Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China;3. Department of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People''s Hospital, Chengdu, China;4. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China;5. Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China;6. Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China;7. Renal Division, The 455 Hospital of Chinese People''s Liberation Army, Shanghai, China;8. Division of Nephrology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY |
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| Abstract: | Arachnoid cysts (AC) located within the interhemispheric fissure are rare, frequently associated with agenesis or hypogenesis of the corpus callosum. The optimal method for surgical treatment is under debate. In this study, we retrospectively reviewed the clinical results of seven infants (five males, two females; mean age, 5.1 months) with large interhemispheric AC who underwent cystoperitoneal shunting (CP) and evaluated the long-term efficacy in terms of clinical data, psychomotor development and neuroimaging. All patients were symptomatic and operated on before they reached 1 year of age. In three patients, additional ventricular catheters were inserted due to concomitant hydrocephalus. The additional catheters were joined with the cyst catheters and the peritoneal catheters with Y-shaped connectors in the same session. The patients were followed up for an average of 57 months (range 24–120 months). The clinical and developmental outcome was good in most patients with complete resolution of symptoms and signs. The developmental outcome scale, which included cognitive and psychomotor development, was “good” (normal) or “fair” (near normal) for six of seven patients. Radiologically, the cyst was completely or nearly totally resolved in five patients, and partially resolved in two. In these symptomatic patients with interhemispheric AC, CP shunting provided favorable treatment outcomes with complete or near-total resolution of symptoms and reduction in cyst size or disappearance of the cyst. |
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