Gavin M Lockard, Keaton Piper, Zeegan George, Adam Alayli, Elliot Neal, Farina Klocksieben, Nour Shaheen, Oliver Flouty
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引用次数: 0
Abstract
Objective: Arachnoid cysts are benign, intradural collections of cerebrospinal fluid that are often asymptomatic but, in rare instances, will grow and may cause symptoms. When these are in the posterior fossa, the symptomatology greatly ranges, and the indications for surgery are not well defined. The objective of this study is to examine radiographic and symptomatic outcomes following surgery for posterior fossa arachnoid cysts (PFAC).
Methods: A literature review was performed utilizing PubMed for all studies involving ≥5 patients with PFACs who underwent surgery. A single-arm meta-analysis was performed to assess the postoperative radiographic improvement. Given the heterogeneous variety of presenting symptoms, these were not conducive to meta-analyses but the outcomes are reported in detail.
Results: Nine publications with 67 patients met inclusion criteria. Excision/fenestration was the most common operation (n = 60). Less common included cystoperitoneal shunts (n = 2), concurrent excision/fenestration and endoscopic third ventriculostomy (n = 4), and one patient who underwent concurrent ventriculoperitoneal/cystoperitoneal shunts. This literature review revealed improvement of headache in 90% of patients; 88% with cerebellar symptoms; 92% with nausea/emesis; 78% with hearing loss; 60% with tinnitus; and 91% with vision deficits. Meta-analysis of 7 studies reporting postoperative radiographic size demonstrated that 75% of people experienced decreased PFAC size (effect size: 0.75, 95% confidence interval: 0.50-0.94).
Conclusions: Although there is a high rate of radiographic improvement for PFAC surgery, there is a wide variety of presenting symptoms with differing postoperative improvement rates. This study reinforces the importance of preoperative counseling regarding symptomatic outcomes for PFAC surgery, with supporting statistical analysis but limited by the sample sizes available.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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