Stereotactic catheter placement in the management of cystic intrcranial lesions : indications and results

Abstract

Stereotactic techniques were used to place a catheter into cystic intracranial lesions in 11 patients. These patients had 4 types of cystic lesions : suprasellar craniopharyngiomas (4), benign epithelial cysts (2), suprasellar arachnoid cysts (3) and tumour cysts (2). Seven patients had subgaleal reservoir placement and four had cystoperitoneal shunt. There was no procedure related morbidity. In all the patients, a post procedure CT scan revealed accurate placement of the catheter. The mean follow-up period was 23 months. During this period, 3 of the 7 patients with reservoir placement had become symptomatic and had to undergo a percutaneous aspiration of the cyst through the subgaleal reservoir. One patient required repositioning of a displaced catheter, and one patient received bleomycin through the reservoir after aspiration of the craniopharyngioma cyst. Eight patients improved and are leading independent lives. Stereotactic catheter placement is a minimally invasive, safe, accurate and simple procedure which can be used in the management of selected cystic masses in the brain. Connection of the catheter to a reservoir or a shunt ensures access to the cyst in case of reaccumulation of its contents and provides continuous drainage of its contents.