Stereotactic internal shunt placement in congenital intracranial cysts.

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Stereotactic internal shunt placement in congenital intracranial cysts.

World Neurosurg. 2018 Dec 18;:

Authors: Lenski M, Biczok A, Tonn JC, Kreth FW

Abstract
INTRODUCTION: Treatment of symptomatic intracranial cysts remains a controversial issue. We here present the risk/benefit profile of a minimally invasive not yet described stereotactic internal shunt implantation technique. The provided data might serve as a reference against which other treatment modalities can be compared.
MATERIALS AND METHODS: From our prospective data base we identified a consecutive series of patients with symptomatic, so far untreated cysts undergoing internal shunting (2009-2017). We estimated rate of clinical symptom improvement (RCSI), rate of cyst reduction (RCR), rate of total complications (RTC) and rate of long term complications (RLTC). A minimal follow up of 6 months was requested. Prognostic factors were obtained from logistic regression models. Cyst recurrence free survival was calculated with the Kaplan-Meier method. Outcome data were compared with that of alternative treatment strategies as described in the literature using the chi-square statistics.
RESULTS: Thirty-eight patients were included. The cysts locations were highly different including the cerebellum (n=2), the brain stem (n=5) and the pineal area (n=4). A cyst associated hydrocephalus (n=6) resolved after treatment. The 2-year cyst recurrence free survival was 97%. RCSI was 91%, RCR 97%, RTC 11%, and RLTC 2.6%. We did not found risk factors associated with RTC. RCSI, RTC, and RLTC compared favorably (p <0.01) with corresponding estimates of alternative treatment concepts (p<0.01).
CONCLUSIONS: The described stereotactic internal shunt implantation technique is safe and can be successfully applied for treatment of cystic formations in any location of the brain.

PMID: 30576829 [PubMed - as supplied by publisher]

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