Surgical intervention strategies for pediatric intracranial arachnoid cysts
10.3760/cma.j.issn.1671-8925.2014.05.017
- VernacularTitle:小儿颅内蛛网膜囊肿手术治疗探讨
- Author:
Zhixiong LIN
1
;
Jianhuang HUANG
;
Wenzhong MEI
;
Yao CHEN
;
Xiyue WU
;
Changzhen JIANG
Author Information
1. 福建医科大学附属第一医院神经外科
- Keywords:
Intracranial arachnoid cyst;
Surgical indication;
Surgical strategy;
Child
- From:
Chinese Journal of Neuromedicine
2014;13(5):508-511
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the operation strategy of pediatric intracranial arachnoid cysts (IACs).Methods Surgical intervention was performed in 76 patients with pediatric IACs,admitted to our hospital from January 2003 to October 2013; cyst-peritoneal shunt was chosen in 40 patients and fistulation in 36 (including microscopic fistulation in 31 and endoscopic fistulation in 5).According to the changes of cyst volume and the relief of symptoms,the efficacy was evaluated,and the complications after operation,including the recent complications (within 2 months of operation) and long-term complications (longer than 2 months of surgery),were observed.Results The efficiency of cysts-peritoneal shunt was 80％ (32/40); the rate of recent complication for patients performed cysts-peritoneal shunt was approximately 17.5％ (7/40),including 3 of CSF leakage,3 of intracranial infection and 1 of wound infection; the rate of long-term complications was approximately 22.5％ (9/40),including 3 of shunt-dependency,2 of intracranial infection,2 of obstruction of the catheter,1 of off the catheter and 1 of skin channel infections.Meanwhile,the efficiency of fistulation was approximately 91.67％ (33/36); the rate of recent complication was approximately 8.33％ (3/36),including 1 of intracranial infection,2 of subdural hematoma; the rate of long-term complications was 0.Significant difference was noted in the surgical efficiency (x2=1.126,P=0.289) and the rate of recent complication (x2=0.707,P=0.401) between cyst-peritoneal shunt and fistulation; however,the rate of long-term complications in patients after cyst-peritoneal shunt insertion was significantly higher than that in patients after fistulation (x2=7.159,P=0.008).Conclusion Fistulation might be the preferred method for pediatric IACs,and shunt should be avoided.
