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Endoscopic treatment of temporal arachnoid cysts in 34 patients

(2015) WORLD NEUROSURGERY. 84(3). p.734-740
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Abstract
INTRODUCTION: Arachnoid cysts are lesions present in 1% of the population and usually found in the temporal fossa. Clinical and radiologic presentations can differ greatly. Despite intensive research, it is still debatable which patients will benefit from surgery. OBJECTIVE: This study aims to investigate the pretreatment parameters influencing the outcome after neuroendoscopic treatment of temporal arachnoid cysts. MATERIALS AND METHODS: A retrospective analysis of 34 patients who underwent an endoscopic fenestration of a temporal arachnoid cyst between July 1991 and December 2013 was performed. RESULTS: In symptomatic patients, there was a clinical improvement in 76.4% of cases. The best results were found in treating symptoms related to intracranial hypertension, acute neurologic defects, and macrocrania. Patients with temporal lobe epilepsy improved after cyst fenestration in 33.3% of cases. Behavioral problems and psychomotor retardation remained largely unchanged. Patients with a complex neurologic presentation, often from a congenital syndrome and combined with an intellectual disability, had the least benefit from endoscopic surgery. Radiologic follow-up showed a cyst volume decrease in 91.2% of cases. Complications were present in 29.4%, but were mostly minor and transient. CONCLUSION: This study demonstrates that patients with symptoms related to intracranial hypertension, acute neurologic deficits, and macrocrania have the best postoperative outcome. Also, patients with ipsilateral temporal lobe epilepsy seem to be good candidates for endoscopic arachnoid cyst fenestrations. In complex neurologic disorders without one of the previously mentioned symptoms, endoscopy remains less successful.
Keywords
POPULATION, INJURY, PATHOGENESIS, FENESTRATION, CHILDREN, SYLVIAN FISSURE, INCIDENTAL FINDINGS, SUBDURAL-HEMATOMA, SURGICAL-TREATMENT, MIDDLE CRANIAL FOSSA, Neurosurgery, Headache, Epilepsy, Cognition

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Chicago
COUVREUR, TIM, GIORGIO HALLAERT, Tatjana Van Der Heggen, EDWARD BAERT, FRANK DEWAELE, Jean-Pierre Kalala Okito, Dimitri Vanhauwaert, Marc Deruytter, Dirk Van Roost, and Jacques Caemaert. 2015. “Endoscopic Treatment of Temporal Arachnoid Cysts in 34 Patients.” World Neurosurgery 84 (3): 734–740.
APA
COUVREUR, T., HALLAERT, G., Van Der Heggen, T., BAERT, E., DEWAELE, F., Kalala Okito, J.-P., Vanhauwaert, D., et al. (2015). Endoscopic treatment of temporal arachnoid cysts in 34 patients. WORLD NEUROSURGERY, 84(3), 734–740.
Vancouver
1.
COUVREUR T, HALLAERT G, Van Der Heggen T, BAERT E, DEWAELE F, Kalala Okito J-P, et al. Endoscopic treatment of temporal arachnoid cysts in 34 patients. WORLD NEUROSURGERY. 2015;84(3):734–40.
MLA
COUVREUR, TIM, GIORGIO HALLAERT, Tatjana Van Der Heggen, et al. “Endoscopic Treatment of Temporal Arachnoid Cysts in 34 Patients.” WORLD NEUROSURGERY 84.3 (2015): 734–740. Print.
@article{7037605,
  abstract     = {INTRODUCTION: Arachnoid cysts are lesions present in 1\% of the population and usually found in the temporal fossa. Clinical and radiologic presentations can differ greatly. Despite intensive research, it is still debatable which patients will benefit from surgery. 
OBJECTIVE: This study aims to investigate the pretreatment parameters influencing the outcome after neuroendoscopic treatment of temporal arachnoid cysts. 
MATERIALS AND METHODS: A retrospective analysis of 34 patients who underwent an endoscopic fenestration of a temporal arachnoid cyst between July 1991 and December 2013 was performed. 
RESULTS: In symptomatic patients, there was a clinical improvement in 76.4\% of cases. The best results were found in treating symptoms related to intracranial hypertension, acute neurologic defects, and macrocrania. Patients with temporal lobe epilepsy improved after cyst fenestration in 33.3\% of cases. Behavioral problems and psychomotor retardation remained largely unchanged. Patients with a complex neurologic presentation, often from a congenital syndrome and combined with an intellectual disability, had the least benefit from endoscopic surgery. Radiologic follow-up showed a cyst volume decrease in 91.2\% of cases. Complications were present in 29.4\%, but were mostly minor and transient. 
CONCLUSION: This study demonstrates that patients with symptoms related to intracranial hypertension, acute neurologic deficits, and macrocrania have the best postoperative outcome. Also, patients with ipsilateral temporal lobe epilepsy seem to be good candidates for endoscopic arachnoid cyst fenestrations. In complex neurologic disorders without one of the previously mentioned symptoms, endoscopy remains less successful.},
  author       = {COUVREUR, TIM and HALLAERT, GIORGIO and Van Der Heggen, Tatjana and Baert, Edward and Dewaele, Frank and Kalala Okito, Jean-Pierre and Vanhauwaert, Dimitri and Deruytter, Marc and Van Roost, Dirk and Caemaert, Jacques},
  issn         = {1878-8750},
  journal      = {WORLD NEUROSURGERY},
  language     = {eng},
  number       = {3},
  pages        = {734--740},
  title        = {Endoscopic treatment of temporal arachnoid cysts in 34 patients},
  url          = {http://dx.doi.org/10.1016/j.wneu.2015.04.053},
  volume       = {84},
  year         = {2015},
}

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