Endoscopic Fenestration of Suprasellar Arachnoid Cysts

A.V. Melnikov, N.V. Arutyunov, A.G. Melikyan

(Burdenko Research Institute of Neurosurgey, Moscow)

Suprasellar arachnoid cysts are a rather rare form of local sequestration of cerebral basal cisterns. The report deals with results of treatment of 23 cases with arachnoid cysts of the interpeduncular cistern and the third ventricle, operated by means of endoscopic fenestration of their walls. Problems of etiology and pathogenesis of these cystic liquor malformations, peculiarities of their clinical picture and diagnosis, as well as endoscopic anatomy and technique of endoscopic interventions in such pathology, are considered.

Fenestration of walls and drainage of cysts led to stabilization of a state in 22 out of 23 cases. The only exception was a patient with bleeding, which did not allow to follow a plan of operation completely and demanded subsequent implantation of a shunt. Considerable regression of symptoms was watched in 15 cases. It allowed to avoid direct traumatic intervention or shunt implantation in the majority of patients. Catamnesis was studied in 13 cases with a period of follow-up, varying from 5.5 months up to 1.5 years on the average. A stable state or its improvement with persistent regression of common cerebral and focal symptoms were typical of all cases. The majority of patients (10) returned to a normal way of life and children continued to study at schools. Thus, endoscopic intervention is both an effective and low-invasive method of treatment of cases with suprasellar arachnoid cysts. It can be recommended as a method of choice.