Original Research Article
Year: 2017 | Month: April | Volume: 7 | Issue: 4 | Pages: 54-60
Management of Intracranial Epidermoids, an Experience at a Tertiary Care Centre in North East India
B.K.Baishya1, Mrinal Bhuyan2, Deep Dutta3, Abinash Dutta3, Rishikant Singh3, Junaid Ahmed3, Rajib Hazarika4
1Professor and HOD, Department of Neurosurgery, Gauhati Medical College and Hospital
2Associate Professor, Department of Neurosurgery, Gauhati Medical College and Hospital
3Senior Resident, Dept. of Neurosurgery, Gauhati Medical College and Hospital
4Associate Professor of Anaesthesiology, Gauhati Medical College and Hospital
Corresponding Author: Deep Dutta
Objective: Epidermoid tumours are benign lesions representing 1% of all intracranial tumours. Surgical treatment is challenging because of its slow growth along the natural neurovascular and cisternal planes. We present in this report our experience of management of these lesions in a cohort in North East India.
Methods: 16 cases of intracranial epidermoids confirmed by computed tomography (CT) and magnetic resonance imaging (MRI) of brain in plain, contrast and other relevant studies were enrolled in the study conducted between January 2010 to December 2015. Demographic data, details of clinical presentation, surgical management and follow up were documented for each patient. All the patients were operated in Gauhati Medical College and Hospital. All patients were followed-up routinely by clinical examination and neuroimaging. Average follow-up was 24 (range-11-60) months.
Results: 11 patients presented with cerebellopontine angle (CPA) epidermoids extending to various basal cerebrospinal fluid (CSF) cisterns, there were 3 cases of para and suprasellar epidermoids and 2 cases of sylvian fissure epidermoids. The patients underwent surgery between 2010 to 2015. The mean age at presentation was 34.32 years with maximum age of 49 years and minimum 17 years in our series. Total excision was achieved in 12(75%) cases. In 4(25%) cases parts of the cyst capsule were left behind because they were adherent to the brainstem and other critical neurovascular structures. One patient died post operatively following aspiration pneumonitis and infection. No recurrence was recorded till writing this paper.
Conclusions: Intracranial epidermoid are rare benign tumours. Total resection should be the goal to minimize the risk of postoperative aseptic meningitis, hydrocephalus, and tumour recurrence. Modern neurosurgical tools and microsurgery techniques have considerably improved the completeness of cyst resection without neurological deficits.
Key words: Intracranial epidermoid, Benign tumours.