Modalities and surgical treatment outcome of intracranial arachnoid cysts

koje su ograničene ćelijama arahnoideje. Mogu se smatrati razvojnom anomalijom u formiranju arahnoidnih cisterni. Ultrastruktura arahnoidnih cista je veoma varijabilna i vrlo često odudara od rezultata tipičnih histoloških studija koje opisuju strukturu zida AC kao identičnu arahnoideji. Arahnoidne ciste se mogu otkriti i u prenatalnom periodu prilikom ultrasonografskog pregleda, kada se vide kao hipoehogene ili anehogene lezije. Za precizniju evaluaciju u ovom periodu koristi se pregled fetusa magnetnom rezonancom (MRI). CT i MRI endokranijuma pokazuju leziju koja je obično neprimetnog zida ispunjena sadržajem koji po svojim neuroradiološkim karakteristikama odgovara likvoru. Za uočavanje karakteristika zida arahnoidne ciste, njenu detaljnu morfologiju i povezanost sa ostalim delovima likvornih puteva neophodno je sprovesti posebne sekvence. Za sada ne postoji konsenzus o tome koji modalitet hirurškog lečenja bi trebalo primeniti kod intrakranijalne arahnoidne ciste određene lokalizacije. Nema još uvek ni jasno formulisanih indikacija za hirurško lečenje. Svaka od primenjenih hirurških tehnika, bila to drenažna operacija ili fenestracija ciste, nosi sa sobom odgovarajući benefit i rizik. MATERIJAL I METODE Ovo je delom retrospektivna kohortna studija sa prospektivnim praćenjem, a delom prospektivna studija, koja je obuhvatila sve pacijente operisane u Klinici za neurohirurgiju Kliničkog centra Srbije, kod kojih je dijagnostikovana intrakranijalna arahnoidna cista, a lečeni su u periodu od 1. januara 2006. godine do 31. decembra 2018. godine...Arachnoid cysts (AC) are extraaxial collections of cerebrospinal fluid surrounded by arachnoid cells. It can be considered as an anomaly during the formation of the arachnoid cisterns. Ultrastrutructure of arachnoid cysts is quite variable and it can frequently significantly differ from the results of the typical histological studies that describe the wall of the AC as identical to the arachnoid membrane. Arachnoid cysts can be diagnosed even in the prenatal period during routine ultrasonographic examination when they are visible as hypoechogenic or anechogenic lesions. In this period, fetal magnetic resonance imaging (MRI) can be used for its more precise evaluation. CT and MRI examination reveal a lesion with an almost unnoticeable wall, filled with content that is identical to CSF in its neuroradiological characteristics. It is necessary to use special MRI sequences to be able to visualize characteristics of the AC's wall, its detailed morphology, and its communication with other sections of the CSF pathway. For the time being, there is no consensus about the optimal treatment modality in arachnoid cysts of certain localization. There are no clear indications for surgical treatment. Every surgical technique used, shunting procedures or cyst fenestration, caries some benefit and risk. MATERIAL AND METHODS This is partly retrospective cohort study with prospective follow-up, and also partly prospective study, that involved all operated patients in the Clinic of Neurosurgery, Clinical Center of Serbia, that have been diagnosed with an intracranial arachnoid cyst, and treated from January 1st, 2006 until December 31st, 2018..