Skip to main content
Top
Published in: Acta Neurochirurgica 11/2019

01-11-2019 | Headache | Original Article - Neurosurgery general

Surgical decompression of arachnoid cysts leads to improved quality of life: a prospective study—long-term follow-up

Authors: Thomas Moss, Christian A. Helland, Svein H. Mørkve, Knut Wester

Published in: Acta Neurochirurgica | Issue 11/2019

Login to get access

Abstract

Background

In a previous study, we reported a short-term (6 months) postoperative improvement of health-related quality of life (Qol) in patients operated for an arachnoid cyst (AC). The aim was to investigate whether this initial improvement was permanent.

Methods

A long-term (5 ± 2 years) prospective study comparing Qol and complaints before and 5 ± 2 years after surgical fenestration for AC in 76 adult patients, using the Short Form 36 (SF-36) scores, Glasgow Benefit Inventory (GBI) questionnaires, and Visual Analogue Scales (VAS) for headache and dizziness, similarly to what they did at short-term follow-up.

Results

At short-term and long-term follow-ups, 73.4% and 82%, respectively, of the patients were better from their headache compared with preoperative scores. The corresponding improvement rates for dizziness were 61.7% (short-term) and 67.9 (long-term). Preoperatively, the mean headache VAS score was 45.6; at short-term follow-up, this was reduced to 25.7, and at long-term follow-up, this further reduced to 24.8. The preoperative mean VAS score for dizziness (35.2) was reduced to 12.2 (short-term) and 13.9 (long-term). The significant postoperative improvement of patient-reported Qol at short-term follow-up remained at long-term follow-up across seven out of eight SF-36 dimensions and three out of four GBI subscale scores. Similar to at short-term follow-up, the Qol improvement is correlated to improvement in headache and/or dizziness.

Conclusions

The previously reported postoperative, short-term improvement in Qol and complaints appears stable, as the improvement remains at long-term follow-up. This suggests that the beneficial effects of surgical treatment are long-lasting.
Literature
1.
go back to reference Arai H, Sato K, Wachi A, Okuda O, Takeda N (1996) Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting. Neurosurgery 39:1108–1112 discussion 1112-1103CrossRef Arai H, Sato K, Wachi A, Okuda O, Takeda N (1996) Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting. Neurosurgery 39:1108–1112 discussion 1112-1103CrossRef
3.
go back to reference Bright R (1831) Serous cysts in the arachnoid diseases of the brain and nervous system, part I: reports of medical cases selected with a view of illustrating the symptoms and cure of diseases by a reference to morbid anatomy. . Longman, Rees, Orme, Brown, Green, vol 2 London Bright R (1831) Serous cysts in the arachnoid diseases of the brain and nervous system, part I: reports of medical cases selected with a view of illustrating the symptoms and cure of diseases by a reference to morbid anatomy. . Longman, Rees, Orme, Brown, Green, vol 2 London
4.
go back to reference Caemaert J, Abdullah J, Calliauw L (1994) Endoscopic diagnosis and treatment of para- and intra-ventricular cystic lesions. Acta Neurochir Suppl 61:69–75PubMed Caemaert J, Abdullah J, Calliauw L (1994) Endoscopic diagnosis and treatment of para- and intra-ventricular cystic lesions. Acta Neurochir Suppl 61:69–75PubMed
5.
go back to reference De Volder AG, Michel C, Thauvoy C, Willems G, Ferriere G (1994) Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J Neurol Neurosurg Psychiatry 57:296–300CrossRef De Volder AG, Michel C, Thauvoy C, Willems G, Ferriere G (1994) Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J Neurol Neurosurg Psychiatry 57:296–300CrossRef
7.
go back to reference Gangemi M, Maiuri F, Colella G, Sardo L (1999) Endoscopic surgery for intracranial cerebrospinal fluid cyst malformations. Neurosurg Focus 6:e6CrossRef Gangemi M, Maiuri F, Colella G, Sardo L (1999) Endoscopic surgery for intracranial cerebrospinal fluid cyst malformations. Neurosurg Focus 6:e6CrossRef
8.
go back to reference Garcia-Bach M, Isamat F, Vila F (1988) Intracranial arachnoid cysts in adults. Acta Neurochir Suppl 42:205–209PubMed Garcia-Bach M, Isamat F, Vila F (1988) Intracranial arachnoid cysts in adults. Acta Neurochir Suppl 42:205–209PubMed
9.
go back to reference Gjerde B, Schmid M, Hammar A, Wester K (2013) Intracranial arachnoid cysts: impairment of higher cognitive functions and postoperative improvement. J Neurodev Disord 5:21 Gjerde B, Schmid M, Hammar A, Wester K (2013) Intracranial arachnoid cysts: impairment of higher cognitive functions and postoperative improvement. J Neurodev Disord 5:21
16.
go back to reference Lodrini S, Lasio G, Fornari M, Miglivacca F (1985) Treatment of supratentorial primary arachnoid cysts. Acta Neurochir 76:105–110CrossRef Lodrini S, Lasio G, Fornari M, Miglivacca F (1985) Treatment of supratentorial primary arachnoid cysts. Acta Neurochir 76:105–110CrossRef
23.
go back to reference Raffel C, McComb JG (1988) To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery 23:338–342CrossRef Raffel C, McComb JG (1988) To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery 23:338–342CrossRef
24.
go back to reference Sgouros S, Chapman S (2001) Congenital middle fossa arachnoid cysts may cause global brain ischaemia: a study with 99Tc-hexamethylpropyleneamineoxime single photon emission computerised tomography scans. PediatrNeurosurg 35:188–194 Sgouros S, Chapman S (2001) Congenital middle fossa arachnoid cysts may cause global brain ischaemia: a study with 99Tc-hexamethylpropyleneamineoxime single photon emission computerised tomography scans. PediatrNeurosurg 35:188–194
25.
go back to reference Sommer IE, Smit LM (1997) Congenital supratentorial arachnoidal and giant cysts in children: a clinical study with arguments for a conservative approach. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 13:8–12. https://doi.org/10.1007/s003810050030 CrossRef Sommer IE, Smit LM (1997) Congenital supratentorial arachnoidal and giant cysts in children: a clinical study with arguments for a conservative approach. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 13:8–12. https://​doi.​org/​10.​1007/​s003810050030 CrossRef
26.
go back to reference Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8:647–650CrossRef Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8:647–650CrossRef
29.
go back to reference van der Meche FG, Braakman R (1983) Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms. J Neurol Neurosurg Psychiatry 46:1102–1107CrossRef van der Meche FG, Braakman R (1983) Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms. J Neurol Neurosurg Psychiatry 46:1102–1107CrossRef
30.
go back to reference Wester K (1996) Arachnoid cysts in adults: experience with internal shunts to the subdural compartment. Surg Neurol 45:15–24CrossRef Wester K (1996) Arachnoid cysts in adults: experience with internal shunts to the subdural compartment. Surg Neurol 45:15–24CrossRef
32.
go back to reference Wester K, Hugdahl K (1995) Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry 59:293–298CrossRef Wester K, Hugdahl K (1995) Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry 59:293–298CrossRef
34.
go back to reference Westermaier T, Schweitzer T, Ernestus RI (2012) Arachnoid cysts. Adv Exp Med Biol 724:37–50CrossRef Westermaier T, Schweitzer T, Ernestus RI (2012) Arachnoid cysts. Adv Exp Med Biol 724:37–50CrossRef
35.
go back to reference Zaatreh MM, Bates ER, Hooper SR, Palmer G, Elmenshawi EE, Courvoisie HE, Greenwood RS (2002) Morphometric and neuropsychologic studies in children with arachnoid cysts. Pediatr Neurol 26:134–138CrossRef Zaatreh MM, Bates ER, Hooper SR, Palmer G, Elmenshawi EE, Courvoisie HE, Greenwood RS (2002) Morphometric and neuropsychologic studies in children with arachnoid cysts. Pediatr Neurol 26:134–138CrossRef
Metadata
Title
Surgical decompression of arachnoid cysts leads to improved quality of life: a prospective study—long-term follow-up
Authors
Thomas Moss
Christian A. Helland
Svein H. Mørkve
Knut Wester
Publication date
01-11-2019
Publisher
Springer Vienna
Keyword
Headache
Published in
Acta Neurochirurgica / Issue 11/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-03990-6

Other articles of this Issue 11/2019

Acta Neurochirurgica 11/2019 Go to the issue