Endoscopic Treatment of Arachnoid Cysts

Background Surgical treatment of arachnoid cysts remains under debate. Although many authors favor endoscopic techniques, others attribute a higher recurrence rate to the endoscope. Objective The authors report their experience with endoscopic procedures for arachnoid cyst. Methods All pure endoscopic procedures for arachnoid cysts performed by the authors were analyzed. Particular reference was given to surgical complications and patient outcome in relation to cyst location and endoscopic technique. Results Sixty-six endoscopic procedures were performed in 61 patients (mean age, 28 years; range, 23 days to 74 years; 35 males, 26 females). The main presenting symptoms were cephalgia (61%), …

Neuronavigation in der Zentralregion: Bedeutung für einzelne Operationsphasen bei verschiedenen Prozesslokalisationen

The neurosurgical treatment of space occupying processes in the central area bears a relatively high risk of either postoperative neurological deficits ("radical approach") or of residual tumor ("conservative approach"). Therefore, special techniques of intraoperative topographic orientation (image-guided surgery) play an important role here. The possible impact of neuronavigation on different neurosurgical steps (craniotomy, corticotomy, localization of the process, definition of borders of resection) was studied in relation to the site of pathology (extraaxial, intraaxial/superficial, intraaxial/deep) in 46 patients harbouring space occupying lesions of the central area. In intraaxial pat…

Abstracts of scientific papers second international symposium on central nervous system monitoring

Brain abscess formation within an endodermal cyst of the frontal lobe: case report.

A 38-year-old man with a right frontal lobe cyst was treated by endoscopic cystoventriculostomy in 1998. Cyst capsule histology revealed surprisingly an endodermal cyst. The patient was reoperated for cyst expansion by endoscopic re-cystoventriculostomy in 2005. In 2007, the patient suffered from brain abscess formation within the cyst which was punctured. The history was positive for a dental infection. In 2008, a recurrent brain abscess in the cyst occurred. The cyst was completely resected. There was no history of trauma or sinusitis. In all, endodermal cysts may mimic a paraxial arachnoid cyst. It may predispose for recurrent brain abscess formation - especially due to bacteraemia. This…

Water Jet Dissection in Neurosurgery: An Update After 208 Procedures With Special Reference to Surgical Technique and Complications

Background Water jet dissection represents a promising technique for precise brain tissue dissection with preservation of blood vessels. In the past, the water jet dissector has been used for various pathologies. A detailed report of the surgical technique is lacking. Objective The authors present their results after 208 procedures with a special focus on surgical technique, intraoperative suitability, advantages, and disadvantages. Methods Between March 1997 and April 2009, 208 patients with various intracranial neurosurgical pathologies were operated on with the water jet dissector. Handling of the device and its usefulness and extent of application were assessed. The pressures encountere…