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Intracranial Cysts Containing Cerebrospinal Fluid-Like Fluid: Results of Endoscopic Neurosurgery in a Series of 64 Consecutive Cases

Talamonti, Giuseppe MD; D'Aliberti, Giuseppe MD; Picano, Marco MD; Debernardi, Alberto MD; Collice, Massimo MD†

Neurosurgery:
doi: 10.1227/NEU.0b013e318207ac91
Concepts, Innovations, and Techniques
Abstract

BACKGROUND: Intracranial cysts containing cerebrospinal fluid (CSF) may be developmental or acquired.

OBJECTIVE: To analyze the results of endoscopic neurosurgery in the management of intracranial CSF cysts.

METHODS: In a 7-year period, 64 consecutive patients underwent endoscopic neurosurgery for CSF cysts. Group 1 consisted of 13 patients with acquired cysts; group 2 included 51 patients with developmental cysts. In all cases, the cyst walls were fenestrated through small burr holes with frameless guided operative endoscopes. Follow-up ranged from 1 to 6 years (mean, 3.4 years).

RESULTS: There were no mortality and no permanent morbidity, apart from a patient (1.6%) who remained neurologically intact but required ventriculoperitoneal shunting because of intraoperative hemorrhage. The planned fenestrations could be performed in all patients except 2, owing to thick, opaque cyst walls. In group 1, 6 patients fully recovered and remained intact throughout the follow-up, whereas 7 improved but had various degrees of neurological disabilities that were related to their initial diseases. Radiological results were excellent in all cases. In group 2, there were 7 asymptomatic patients who remained unchanged and 44 “symptomatic” patients: 40 (91%) clinically improved, 4 (9%) remained unchanged, and none worsened. Cyst size decreased in 37 patients (74%) and remained unchanged in 13 (26%).

CONCLUSION: In this series, patients of different ages, harboring cysts of various sizes and locations, could be satisfactorily treated with endoscopic neurosurgery.

Author Information

Department of Neurosurgery, Niguarda Ca'Granda Hospital, Milan, Italy

†Deceased.

Received, January 19, 2010.

Accepted, August 11, 2010.

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Correspondence: Dr Giuseppe Talamonti, MD, Department of Neurosurgery, Niguarda Ca'Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. E-mail: giuseppe.talamonti@ospedaleniguarda.it

Copyright © by the Congress of Neurological Surgeons