Suprasellar cysts: surgical treatment and results

The purpose of this paper is to present the clinical picture, diagnostic studies, and treatment of 5 cases of suprasellar cyst. The clinical symptoms and signs result from increased intracranial pressure without lateralizing signs (midline syndrome) and direct compression of the adjacent structures (hypothalmopituitary syndrome). The findings of computerized transmission tomography (CTT) and cerebral angiography in patients with suprasellar cyst are very similar to those of severe hydrocephalus. Cerebral angiography, however, reveals in inordinate mass effect in the parasellar area. Even though the location of the parasellar cyst is well demonstrated on postventriculoperitoneal shunt CTT scans, pneumonencephalography is necessary to confirm the diagnosis. We treated our patients with uni- or bilateral ventriculoperitoneal shunts, followed by craniotomy and cystosubarachnoid marsupialization. Cystoperitoneal shunting was performed after craniotomy in some instances, in place of it in others.