Surgical treatment of a large arachnoid cyst with multiple complications

Abstract

Introduction. Arachnoid cysts are common among the general population. Best treatment option is still the subject of much debate. Surgical options include open-craniotomy or endoscopic cyst fenestration, cysto-peritoneal shunt insertion, or marsupialization via craniotomy. The aim of this article was to present a patient with an extremely large arachnoid cyst which occupied almost the entire left hemisphere. Case outline. The patient with a large symptomatic arachnoid cyst was treated by craniotomy and open fenestration. The patient suffered multiple postoperative complications, such as imidiate intracerebral hemorrhage due to hypertension, obstructive hydrocephalus, and a fresh ulcer in the bulbus duodeni. All the complications were successfully treated. Conclusion. Since the best treatment option is still the subject of much debate, we think that personalized medical approach is the best one, taking into account patient symptoms, localization and size of the cyst, patient’s general condition, and surgeon’s familiarity with the procedure.

Keywords

• Arachnoid cysts
• postoperative complications
• personalized medical approach