Does subjective improvement in adults with intracranial arachnoid cysts justify surgical treatment?

• OBJECTIVE Subjective improvement of patients who have undergone surgery for intracranial arachnoid cysts has justifed surgical treatment. The current study aimed to evaluate the outcome of surgical treatment for arachnoid cysts using standardized interviews and assessments of neuropsychological function and balance. The relationship between arachnoid cyst location, postoperative improvement, and arachnoid cyst volume was also examined. METHODS The authors performed a prospective, population-based study. One hundred nine patients underwent neurological, neuropsychological, and physiotherapeutic examinations. The arachnoid cysts were considered symptomatic in 75 patients, 53 of whom agreed to undergo surgery. In 32 patients, results of the differential diagnosis revealed that the symptoms were due to a different underlying condition and were unrelated to an arachnoid cyst. Neuropsychological testing included target reaction time, Grooved Pegboard, Rey Auditory Verbal Learning, Rey Osterrieth complex fgure, and Stroop tests. Balance tests included the extended Falls Effcacy Scale, Romberg, and sharpened Romberg with open and closed eyes. The tests were repeated 5 months postoperatively. Cyst volume was pre-and postoperatively measured using OsiriX software. RESULTS Patients who underwent surgery did not have results on balance and neuropsychological tests that were different from patients who declined or had symptoms unrelated to the arachnoid cyst. Patients with a temporal arachnoid cyst performed within the normal range on the neuropsychological tests. Seventy-seven percent of the patients who underwent surgery reported improvement, yet there were no differences in test results before and after surgery. Arachnoid cysts in the temporal region and posterior fossa did not influence the preoperative results of neuropsychological and motor tests. The arachnoid cyst volume decreased postoperatively (p <∗0.0001), but there was no relationship between volume reduction and clinical improvement. CONCLUSIONS The results of this study speak against objectively verifable improvement following surgical treatment in adults with intracranial arachnoid cysts. © AANS 2018.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Balance testing

Cyst volume

Intracranial arachnoid cysts

Neuropsychological testing

adult

anterior cingulate

aphasia

arachnoid cyst

Article

assessment of humans

balance impairment

bone graft

clinical evaluation

clinical examination

cognitive defect

controlled study

cranioplasty

differential diagnosis

dizziness

dorsolateral prefrontal cortex

epidural hematoma

Falls Efficacy Scale

female

follow up

grooved pegboard test

head injury

headache

human

hygroma

liquorrhea

major clinical study

male

meningitis

neuralgia

neuropsychological test

nuclear magnetic resonance imaging

outcome assessment

population research

posterior fossa

postoperative period

priority journal

prospective study

reoperation

Rey auditory verbal learning test

Rey Osterrieth complex figure test

Romberg test

seizure

Stroop test

subdural empyema

subdural hematoma

temporal lobe

visual disorder

volumetry

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)