Türk Nöroşirürji Dergisi 2003 , Vol 13 , Num 2
TREATMENT OF SYLVIAN ARACHNOID CYTS ADMITTING WITH HEMORRHAGE
Adnan DAĞÇINAR1, M. Mehmet ÖZEK1, Hakan KARABAĞLI2, Türker KILIÇ1, M. Necmettin PAMİR1
1Marmara Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, İstanbul
2Haydarpaşa Numune Hastanesi, İstanbul
Objective: Sylvian arachnoid cysts may become symptomatic because of the subdural or/and intracystic hemorrhage. The aim of this study is to discuss the findings and treatment alternatives of subdural hematoma accompanying sylvian arachnoid cysts of three cases admitted to Marmara University School of Medicine, Department Of Pediatric Neurosurgery between years 1999-2000.

Methods: This study includes, 3 cases of sylvian arachnoid cysts admitted to our department with subdural or / and intracystic hematoma clinic. Preoperative and postoperative clinical and radiological findings with surgical features are discussed with the rewiev of the literature.

Results: All of the cases were female and the average age was 14,3. Headache and epileptic seizure were the prominent symptoms and temporal bulging, papiledema and hemiparesis were the major findings. Intracystic and / or subdural hematomas accompanying sylvian arachnoid cysts were detected in all of the patients. Hematoma drainage and cyst excision and fenestration to the basal cistems were accomplished in all cases. Average follow up period is 22 months and all of the patients are symptom free.

Conclusion: Treatment altematives are very controversial for subdural or intracystic hematomas accompanying svlvian arachnoid cvts. Operative approach must be considered individually for each case, according to the patient' s age, symptoms and localization of the hematoma (Intracystic or / and subdural). Hematoma drainage, cyst excision and fenestration is the preferred technique for pediatric patients. Anahtar Kelimeler : Sylvian arachnoid cysts, hematoma