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Objective improvement in adults with cerebellopontine angle arachnoid cysts after surgical treatment

  • Original Article - Neurosurgery general
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Abstract

Background

Intracranial arachnoid cysts are extra-axial benign lesions mainly found in the middle cerebral fossa. Rare case series report various cranial nerve dysfunctions associated with cerebellopontine angle (CPA) cysts and there is no consensus with regard to their surgical management; some reports claiming that subjective improvement in adults with intracranial arachnoid cysts cannot justify surgical treatment.

Methods

This retrospective study included all 12 consecutive adult patients treated by microsurgical fenestration for symptomatic CPA arachnoid cysts between 2010 and 2019 and using a retrosigmoid approach. Demographic, clinical, surgical, and radiological data were collected from medical files.

Results

The main symptoms were audiovestibular in 9 patients (75%) complaining of dizziness and 6 patients (50%) with hearing loss. In addition, 3 patients (25%) reported tinnitus, 3 patients (25%) presented vasovagal syncope, and 1 patient (8.3%) reported facial pain. Surgery improved 5 patients (83%) with pre-operative hearing loss, 7 patients (78%) reporting dizziness, and all patients with vasovagal syncope. All of the patients recovered from at least one symptom. No recurrence was observed with a mean follow-up of 5.5 years.

Conclusion

Although most arachnoid cysts are asymptomatic, the CPA location may lead to cranial nerve impairments. Microsurgical fenestration seems to be a simple, safe, and effective technique.

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Authors and Affiliations

  1. Department of Neurosurgery – AP-HP, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, 47-83 boulevard de l’hôpital, 75013, Paris, France

    Yohan Caudron & Michel Kalamarides

  2. Sorbonne Université, APHP.Sorbonne Université, Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Paris, France

    Yohan Caudron, Olivier Sterkers, Daniele Bernardeschi & Michel Kalamarides

  3. Department of Otology – AP-HP, Hôpitaux Universitaires Pitié Salpêtrière–Charles Foix, Paris, France

    Olivier Sterkers & Daniele Bernardeschi

Authors
  1. Yohan Caudron
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  2. Olivier Sterkers
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  3. Daniele Bernardeschi
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  4. Michel Kalamarides
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Corresponding author

Correspondence to Michel Kalamarides.

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Ethics approval and consent to participate

Informed consent was not required for a retrospective study. Authorization was obtained from the ethics board of the French Society of Neurosurgery (n° IRB00011687 College de neurochirurgie IRB #1: 2020/32).

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The authors declare no conflict of interest.

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This article is part of the Topical Collection on Neurosurgery general

Supplementary information

Supplementary Figure 1

– Examples of ABR. ABR on the left ear with normal waves I, III and V amplitude and normal wave V latency (< 5.8ms). ABR on the right ear show quantitative (decreased amplitude) and qualitative (wave V latency > 5.8ms) alterations (Patient 10) (JPG 118 kb)

Supplementary Figure 2

– Examples of VNG. (a) normoreflexia (Patient 12), (b) right compensated hyporeflexia (Patient 10) and (c) right non-compensated hyporeflexia (Patient 9) (JPG 96 kb)

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Caudron, Y., Sterkers, O., Bernardeschi, D. et al. Objective improvement in adults with cerebellopontine angle arachnoid cysts after surgical treatment. Acta Neurochir 163, 753–758 (2021). https://doi.org/10.1007/s00701-021-04721-6

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  • DOI: https://doi.org/10.1007/s00701-021-04721-6

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