An evaluation of the surgical treatment of intracranial arachnoid cysts in children.

In the period 1976-1987, the number of intracranial arachnoid cysts treated at our institute was 60: sylvian, 29; midline supratentorial, 13; subtentorial, 18. The diagnosis was mainly made by means of the results of a combination of CT, dynamic cisternography, and ventriculography. Based on an analysis of the preoperative investigations and operative results, an attempt was made to determine the appropriate treatment more precisely in cysts at different locations. The direct microsurgical approach with membrane excision was mainly used in combination with a preliminary VA shunt to treat hydrocephalus. The direct approach was supplemented with secondary cavity shunting in 5 cases. In more than half of the patients we used membrane excision alone (mainly children with sylvian cysts). In suprasellar cysts we consider the subfrontal approach to be more appropriate than the transventricular one. We restricted the use of primary cyst shunting as an alternative treatment to only 3 infants, with huge cysts. The follow-up reveals that 82.7% of the cases were favorable affected to varying degrees.