Quistes aracnoideos de la cisura coroidea y epilepsia parcial compleja / Arachnoid cysts of the choroidien fissure and parcial complex epilepsy

El propósito del presente trabajo es mostrar la asociación de epilepsia parcial compleja con quistes aracnoideos de la fisura coroidea. Examinamos los informes de 71 pacientes portadores de quistes aracnoideos, estudiados por IRM o TAC, 10 fueron quistes de la fisura coroidea. De los 10 pacientes portadores de quistes aracnoideos de la cisura coroidea 5 presentaron antecedentes de epilepsia parcial compleja (AU)

Tratamiento endoscopico de los quistes aracnoideos supratentoriales de linea media / Endoscopic treatment of supratentorial midline arachnoid cysts

Objetivo: el proposito de esta presentacion es analizar el rol de la neuroendoscopia en el tratamiento de los quistes aracnoideos supratentoriales de linea media. Descripcion: se han utilizado neuroendoscopios rigidos Wolf, Storz o Aesculap segun los casos. El instrumental auxiliar utilizado ha consistido en pinza de biopsia, tijera, electrodo mono y/o bipolar y cateter balon tipo Fogarty 3F. El equipamiento complementario lo constituyen una videocamara de alta resolucion, una fuente de luz fria y un monitor de alta definicion, de acuerdo a su disponibilidad. Las imagenes han sido registradas por medio de un capturador fotografico digital y de un videograbador. Resultados: la tecnica neuroendoscopica ha permitido el tratamiento quirurgico de los quistes aracnoideos supratentoriales de linea media en forma minimamente invasiva comunicando estas lesiones con las cisternas basales y/o el sistema ventricular. Conclusion: la vecindad de estas lesiones con el sistema ventricular resulta ideal para su fenestracion endoscopica y comunicacion con las vias de circulacion del liquido cefalorraquideo (AU)

Quiste aracnoide espinal: presentacion de un caso / Spinal arachnoidal cyst: case presentation

Objective: to present a case of an extradural arachnoid dorsal cyst in a 30 year-old woman. Description: a patient (30 years, female) who refers eight-months history of radicular pain and progressive right leg weakness, with exacerbations and remissions. On examination the patient had righ hemihypesthesia with T-10 sensitive level and right leg 4/5 palsy. Magnetic resonance imaging showed an extradural cystic lesion in T11-T12 hypointense in T1 and hyperintense en T2, without contrast enhancement. The cyst contained fluid tha demonstrated the same signal as cerebrospinal fluid. Intervention: After laminectomy of T-10 and T-11 the cystic lesion was exposed. The cyst was filled with CSF-fluid like. A surgical resection of the cyst wall was made. A small dural defect that allowed communication between the cyst and the subarachnoid space was revealed during the surgery, and a closure was made with a suture. Histopathological examination confirmed a cystic lesion with a single-cell lining of meningothelial cells, that contained no neural tissue neither ganglion cells. Conclusion: extradural arachnoid cysts showed characteristic images in the MRI in the preoperative stage. There was no need to use other invasive methods such as myelography or mielotomography to decide the indication for surgery or the surgical technique. Definitive diagnosis is based on the free comunication with the subarachnoidal space and the lack of neural tissue in the histopatological examination, which allowed us to distinguish between extradural arachnoid cysts and Tarlov cysts (AU)

Endoscopic treatment of posterior fossa arachnoid cysts

Objectives: the aim of this paper is to present the results of endoscopic intervention in retrocerebellar arachnoid cysts. Material and methods: the patients with posterior fossa arachnoid cysts in which a neuroendoscopic intervention had been done between 2000 and 2004 were retrospectivelly reviewed. Age, gender, presenting symptoms and signs, radiological findings and previous modes of treatment were evaluated. A rigid neuroendoscope was used in all procedures. Results: there were 6 boys and 3 girls who ranged in age from 1 month to 16 years (mean 29.9 months). Endoscopic cyst fenestration was successful in 7 of 9 patients. Of the 4 patients who had been previously shunted, 3 became shunt free. Conclusion: endoscopic cysto cisternostomy should be the first step in the management of posterior fossa arachnoid cyst in the institutions where neuroendoscopy is routinely practiced (AU)