The diagnosis and neuroendoscopic treatment of noncommunicating intracranial arachnoid cysts

BackgroundThe aim of this study was to explore the CTC classification, establish surgical indication, and evaluate neuroendoscopic treatment of IAC.MethodsComputed tomographic cisternography was applied to screen NCIAC cases out of 22 patients with IAC. Noncommunicating intracranial arachnoid cyst cases were treated with neuroendoscopic fenestration between IAC and cerebral cistern/ventricle with rigid neuroendoscope.ResultsAll the NCIAC patients had definite neurologic findings. Postoperatively, the clinical status and situations of all the patients were improved, and some patients were even cured. Only 1 case suffered complicated chronic subdural hematoma and was cured by burr hole drainage. Follow-up CT scan of 9 cases showed that the cysts decreased markedly in size; most of the surrounding spaces were filled by normal cerebral tissue.Conclusion(1) CTC is specific for the differential diagnosis of IAC, which can be classified into CIAC and NCIAC with CTC. (2) NCIAC with definite neurologic findings have surgical indication. (3) Compared with traditional treatments, neuroendoscopic cystic fenestration is more effective and minimally invasive with less mortality and morbidity.