두개강내 지주막 낭종의 치료 및 결과

Abstract

Sixty-four patients with intracranial arachnoid cyst were treated at the Department of Neurosurgery, Yonsei University College of Medicine between 1985 and 1992. Among them, forty-eight patients received operation. The purpose of this study was to review our surgical results and find out the most effective surgical procedure for arachnoid cysts in each location. The thirty-one patients with the supratentorial arachnoid cyst showed the mass effect or subdural hematoma on preoperative CT scan. They were treated with marsupialization, cystoperitoneal shunt, fenestration with cystoperitoneal shunt, and cystoperitoneal shunt with endoscopy. The fenestration with cystoperitoneal shunt showed the best result in supratentorial arachnoid cysts. The ten patients with the midline arachnoid cyst showed the hydrocephalus on CT scan. They were treated with open fenestration with ventriculoperitoneal shunt, endoscopic fenestration. Open fenestration, endoscopic fenestration with ventriculoperitoneal shunt and cystoperitoneal shunt. The endoscopic fenestration showed the best result in midline arachnoid cysts. The seven patients infratentorial arachnoid cysts also presented with hydrocephalus on initial CT scan. The open fenestration with ventriculoperitoneal shunt, open fenestration, endoscopic fenestration, and cystoperitoneal shunt were surgical procedure for these. The cystoperitoneal shunt showed the best result in infratentorial arachnoid cysts. The complications of treatment related with shunt operation, were relived with shunt revision. Forty-five cases among forty-eight operated cases had good clinical outcome. The most appropriate surgical method for arachnoid cyst were discussed.