Background: We have gradually adopted a liberal attitude for surgical decompression of arachnoid cysts. This study describes the results from our institution.
Methods: Long-term clinical and neuroimaging results of 156 adult patients (age > 16 years) operated for arachnoid cysts in our department in the period January 1987-September 2004 were assessed from the medical and neuroimaging records, in combination with a questionnaire.
Results: The clinical and/or neuroimaging results indicated that the cyst was successfully decompressed in all the patients. 82% of the patients were asymptomatic or had insignificant complaints at follow-up. 12% reported no symptom relief, whereas 6% experienced a worsening. The cyst disappeared after surgery, or was reduced to <50% of the preoperative volume, in 66%. In another 24%, the postoperative volume was also reduced, but was larger than 50% of the original cyst volume. No reduction of the fluid volume was observed in only 10%. There was no association between volume reduction and clinical improvement. A complication occurred in 26 patients (17%), all with temporal cysts, leading to a reoperation in 11 patients (7.1%). In only two patients, the complication caused a permanent, slight disability.
Conclusion: Decompression of arachnoid cysts yields a substantial clinical benefit with a low risk of severe complications.
- arachnoid cysts
- decompressive surgery
- population-based study