Surgical decompression of arachnoid cysts leads to improved quality of life: a prospective study—long-term follow-up

• Published in: Acta neurochirurgica 2019-11, Vol.161 (11), p.2253-2263
• Main Authors: Moss, Thomas, Helland, Christian A., Mørkve, Svein H., Wester, Knut
• Format: Article
• Language: English
• Subjects: Adult; Arachnoid; Arachnoid Cysts - surgery; Brain diseases; Cysts; Decompression; Decompression, Surgical - adverse effects; Decompression, Surgical - methods; Dizziness - epidemiology; Female; Headache; Headache - epidemiology; Headaches; Humans; Interventional Radiology; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Neurosurgery general; Original Article - Neurosurgery general; Postoperative Complications - epidemiology; Quality of Life; Short term; Surgical Orthopedics; Surveys and Questionnaires
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-019-03990-6

Background In a previous study, we reported a short-term (6 months) postoperative improvement of health-related quality of life (Qol) in patients operated for an arachnoid cyst (AC). The aim was to investigate whether this initial improvement was permanent. Methods A long-term (5 ± 2 years) prospective study comparing Qol and complaints before and 5 ± 2 years after surgical fenestration for AC in 76 adult patients, using the Short Form 36 (SF-36) scores, Glasgow Benefit Inventory (GBI) questionnaires, and Visual Analogue Scales (VAS) for headache and dizziness, similarly to what they did at short-term follow-up. Results At short-term and long-term follow-ups, 73.4% and 82%, respectively, of the patients were better from their headache compared with preoperative scores. The corresponding improvement rates for dizziness were 61.7% (short-term) and 67.9 (long-term). Preoperatively, the mean headache VAS score was 45.6; at short-term follow-up, this was reduced to 25.7, and at long-term follow-up, this further reduced to 24.8. The preoperative mean VAS score for dizziness (35.2) was reduced to 12.2 (short-term) and 13.9 (long-term). The significant postoperative improvement of patient-reported Qol at short-term follow-up remained at long-term follow-up across seven out of eight SF-36 dimensions and three out of four GBI subscale scores. Similar to at short-term follow-up, the Qol improvement is correlated to improvement in headache and/or dizziness. Conclusions The previously reported postoperative, short-term improvement in Qol and complaints appears stable, as the improvement remains at long-term follow-up. This suggests that the beneficial effects of surgical treatment are long-lasting.