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Surgery for intracranial arachnoid cysts in children—a prospective long-term study

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Abstract

Purpose

Intracranial arachnoid cysts are cystic malformations found in both adults and children. While many are asymptomatic, some cause symptoms and warrant surgical treatment. In this prospective population-based study, we aimed to study the short- and long-term outcome after surgical intervention in children with arachnoid cysts referred to our centre.

Methods

Twenty-seven pediatric patients (13 f. 14 m, mean age 9.4 years) with de novo cysts were consecutively included during a 5-year period. The presenting symptoms were headache (n = 12), balance disturbance and dizziness (n = 6), seizures (n = 6), hydrocephalus (n = 5), and macrocephaly (n = 1). Twenty-two patients underwent surgical treatment with either microsurgical (n = 17) or endoscopic fenestration (n = 5) of the cyst wall. Cyst volume was measured with OsiriX® software pre- and postoperatively. Short-term and long-term follow-up of all patients was conducted 3 months and 8.6 years (7–10.5 years) postoperatively.

Results

Three months after surgery, 59 % of the patients were improved regarding at least one major complaint, and average cyst volume was reduced to 33.3 ml (0–145 ml). At the long-term follow-up of 8.6 years, 77 % of the patients were improved regarding at least one symptom but subjective symptoms remained in 59 %. There was no permanent postoperative morbidity. We found no association between radiological reduction of cyst volume and clinical improvement.

Conclusion

Our findings support a restrictive attitude to surgery for intracranial arachnoid cysts, in the absence of objectively verified symptoms and signs or obstruction of CSF pathways.

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Acknowledgments

Bengt Bengtsson at Statistiska Konsultgruppen for statistical analysis. Funding was received from Göteborg Foundation for Neurological Research (ISNF), Edit Jacobson’s Foundation, Rune and Ulla Amlövs Foundation, and John and Brit Wennerström Foundation. The funders had no role in the study design, the collection and analysis of the data, data interpretation, or the writing of the paper.

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Authors and Affiliations

  1. Department of Neurosurgery, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden

    Katrin Rabiei, Mats Johansson Högfeldt & Magnus Tisell

  2. Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Katrin Rabiei, Roberto Doria-Medina & Magnus Tisell

Authors
  1. Katrin Rabiei
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  2. Mats Johansson Högfeldt
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  3. Roberto Doria-Medina
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  4. Magnus Tisell
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Correspondence to Katrin Rabiei.

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None of the authors report any conflict of interest in relation to this study.

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Rabiei, K., Högfeldt, M.J., Doria-Medina, R. et al. Surgery for intracranial arachnoid cysts in children—a prospective long-term study. Childs Nerv Syst 32, 1257–1263 (2016). https://doi.org/10.1007/s00381-016-3064-8

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  • DOI: https://doi.org/10.1007/s00381-016-3064-8

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