The Clinical Outcomes of Craniotomy in the Management of Cranial Arachnoid Cyst: An experience from Ali Institute of Neurosciences, Irfan General Hospital Peshawar: A Retrospective Case Series

Abstract

Objective:  Intracranial arachnoid cyst is a non-neoplastic clinical entity that develops due to the splitting or duplication of the membrane surrounding the arachnoid matter. Nonspecific symptoms are usually treated conservatively. If the symptoms are severe, progressive, and disabling, surgical intervention is indicated. We aimed to evaluate the effectiveness and clinical outcomes of craniotomy in the management of arachnoid cysts.

Material and Methods:  A retrospective case series study was conducted at Ali Institute of Neurosciences, Irfan General Hospital from the records of the past 8 years. Clinical records were analyzed. Thirty-six patients were included in our study as they were diagnosed as having symptomatic and progressive symptoms which required surgical intervention. In those patients, the standard procedure of Craniotomy was performed. Clinical and neuroimaging outcome scales were used.

Results:  Mean age of the participant was 9 years at the time of surgery. Most of the arachnoid cysts were located in the temporal area 20 (43%), followed by post fossa 4(9%). The majority of the patients (63%) were characterized in COS 1 on the clinical outcome scale while there was no patient in COS 4 category. More than half of the patients (54%) had the cyst reduced to less than 50% of the original volume (NOS 2) while 25 percent of patients had the cyst size reduced but was still greater than 50% (NOS 3).

Conclusion:  Craniotomy, an open surgical procedure is an effective intervention in improving clinical and radiological outcomes. However, it is also associated with significant recurrence rates along with other complications.