Surgical treatment for arachnoid cysts in adults: Clinical, radiological, neurocognitive and patient-reported outcomes
Abstract
Introduction: Intracranial arachnoid cysts (AC) are usually incidental findings, most often managed conservatively. Evidence of the effectiveness of surgical management in symptomatic patients is limited.
Research question: This case series evaluates clinical, radiological, neurocognitive, and patient-reported outcomes (PROMs) of surgically treated AC patients.
Methods: Retrospective case series of surgically treated adult AC patients between 2010 and 2023. The primary outcome was improvement of presenting symptoms. Secondary outcomes included cyst volume, neurocognitive outcomes, revision rates, PROMs, and morbidity.
Discussion: Between 2010 and 2023, 2537 AC were radiologically diagnosed at the University Hospital Basel, 18 patients (0.71%) underwent surgical treatment. Mean age was 51 ± 16 years. Cyst locations included convexity (44.4%), retrocerebellar (22.2%), middle fossa (16.7%), cerebellopontine angle (5.6%), and quadrigeminal cistern (5.6%). Common presenting symptoms were headache (66.7%), cognitive deficits (33.3%) and nausea (33.3%). Surgical techniques included endoscopic fenestration (77.8%), microsurgical fenestration (16.7%), and cystoperitoneal shunting (5.6%). During a mean follow-up of 2.9 ± 2.4 years, mean cyst volume decreased by 44.5 ± 30.4%. Clinical improvement was observed in 17 (94.4%) patients. Four (22.2%) patients underwent neuropsychological examinations pre- and post-surgery, showing neurocognitive deficits in the functional domains of memory…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 18 participants or records.
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