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Open Access Research article

The effectiveness of neuroendoscopic versus non-neuroendoscopic procedures in the treatment of lateral ventricular cysts: a retrospective medical record review study

Peng Zhao1, Xinsheng Wang1, Chuzhong Li2, Songbai Gui1, Xuyi Zong1 and Yazhuo Zhang2*

Author Affiliations

1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, People’s Republic of China

2 Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100050, People’s Republic of China

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BMC Neurology 2013, 13:59  doi:10.1186/1471-2377-13-59

Published: 13 June 2013

Abstract

Background

The aim of this study was to assess the effectiveness of neuroendoscopy compared with non-neuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles.

Methods

The medical records of 28 patients with arachnoid membrane cysts in the lateral ventricles who were treated with neuroendoscopy and 39 such patients treated with non-neuroendoscopic techniques using classic treatment procedures were reviewed. The neuroendoscopic approach combined craniotomy, corticectomy, lesion resection and cyst ventriculostomy or cyst cisternostomy to restore normal cerebrospinal fluid circulation. The non-neuroendoscopic techniques included craniotomy, corticectomy, and lesion resection performed under a microscope. Clinical outcomes of symptoms and cyst size change on imaging were compared between the two treatment groups during follow-up (range: 1–5 years).

Results

Patients in the neuroendoscopy group had significantly less blood loss (P < 0.001) and shorter operative time (P < 0.001), better marked improvement in symptoms (64.3% vs. 5.1%, respectively), and a higher total resection rate (92.9% vs. 66.7%; P = 0.011) compared with the patients in the non-neuroendoscopy group. In the neuroendoscopy group there was no cyst recurrence whereas in the non-neuroendoscopy group 8 (20.5%) patients had cyst recurrence. However, all patients in the neuroendoscopy group had postoperative transient fever and 8 (28.6%) patients had subdural fluid accumulation which was treated and subsequently resolved during follow-up. These symptoms did not occur in the non-neuroendoscopy group.

Conclusion

We found that neuroendoscopic therapy for arachnoid cysts in the lateral ventricles was more efficacious than non-neuroendoscopic methods. Our results indicate that neuroendoscopy may produce better clinical outcomes than non-neuroendoscopic procedures in treating patients with arachnoid cysts in the lateral ventricles.

Keywords:
Neuroendoscope; Lateral ventricle; Arachnoid cyst; Intracranial lesion