Intracranial epidermoid--a 10-year study

Area of Science:

• Neurosurgery
• Neurology
• Neuroradiology

Background:

• Intracranial epidermoid cysts are congenital tumors, often presenting with neurological deficits based on location.
• These tumors are typically slow-growing and can reach significant sizes before diagnosis.

Purpose of the Study:

• To analyze the clinical presentation, surgical management, and outcomes of intracranial epidermoid tumors.
• To evaluate the diagnostic accuracy of CT scans and the incidence of postoperative complications.

Main Methods:

• Retrospective review of 28 patients with intracranial epidermoid tumors operated over 10 years.
• Analysis of patient demographics, tumor location, presenting symptoms, diagnostic methods, surgical approaches, and outcomes.

Main Results:

• Common locations included the cerebellopontine angle (n=15) and fourth ventricle (n=6).
• Presenting symptoms varied by location, with hearing loss/vertigo common in CPA and gait disturbances in fourth ventricle tumors.
• CT scan was diagnostic in 23 cases; 16 patients had ventriculomegaly requiring shunting.
• Total removal was achieved in 6, near-total in 14, and partial in 8 cases. Five patients died, and complications included chemical meningitis (7) and worsened neurological deficits (5).

Conclusions:

• Surgical management of intracranial epidermoids can yield satisfactory outcomes with appropriate treatment.
• Early diagnosis and surgical intervention are crucial for managing these tumors and preventing long-term deficits.
• While surgical risks exist, most complications are manageable, and long-term follow-up indicates good prognosis for most patients.