Presentation and management of suprasellar arachnoid cysts

Review of 20 cases

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✓ The clinical presentation and treatment of suprasellar arachnoid cysts remain controversial. The authors review 20 cases treated at their institution and 86 cases from the literature reported in sufficient detail for analysis. The high frequency of endocrinological disorders, which not only persist following treatment but may also develop years later despite the satisfactory decrease in volume of the cyst, are emphasized and documented. The difficulties of management are discussed, including: subfrontal approaches to these cysts; removal and/or marsupialization of the cysts, procedures that are frequently dangerous and ineffective; and ventricular shunting which often leads to a paradoxical increase in the size of the cysts. The authors emphasize the advantages of percutaneous ventriculocystostomy, which is a simple, benign, and efficacious procedure.

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Address reprint requests to: Alain Pierre-Kahn, M.D., Assistance Publique, Hôpitaux de Paris, Groupe Hospitalier Necker — Enfants Malades, 149 rue de Sèvres, 75743 Paris 15, France.

© AANS, except where prohibited by US copyright law.

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