Advertisement

Neurocognitive profile in children with arachnoid cysts before and after surgical intervention

  • Kyung Hyun Kim
  • Ji Yeoun Lee
  • Ji Hoon Phi
  • Byung-Kyu Cho
  • Min-Sup ShinEmail author
  • Seung-Ki KimEmail author
Original Paper

Abstract

Objectives

Treatment indications for arachnoid cysts are not clear. Some surgeons take improvement in neurocognitive function into account as a surgical indication for arachnoid cysts. However, only a few studies have evaluated the relationship between arachnoid cysts and neurocognitive function. Furthermore, studies that analyze neurocognitive function as an effect of arachnoid cyst surgery are even rarer. The purpose of this study was to analyze the neurocognitive function scores of children with arachnoid cysts before and after surgery and to examine whether surgical treatment led to improved neurocognitive function.

Methods

From June 2009 to August 2012, data for 24 children diagnosed with arachnoid cysts who underwent surgery at Seoul National University Children’s Hospital were analyzed. Pre-operative and post-operative cyst volume was assessed and neurocognitive function was tested using the Korean version of the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Bender-Gestalt Test (BGT). Comparison of pre- and post-operative profiles by laterality of the arachnoid cyst was performed.

Results

Patients had age-appropriate full-scale intelligent quotients (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) pre-operatively, which were maintained after surgery. Of the subtests, Block Design showed significant improvement post-operatively (p = 0.021). This means that visuo-spatial integration and mental construction abilities were improved after surgery. Patients with left or right arachnoid cysts did not show statistically significant changes in FSIQ, VIQ, or PIQ after surgery (110.21 versus 113.95, p = 0.307; 108.92 versus 111.54, p = 0.368; 107.88 versus 111.04, p = 0.152, respectively). Subanalysis showed that the pre- and post-operation VIQ mean scores of the patients with right arachnoid cysts were significantly higher (p < 0.054) than those of the patients with left arachnoid cysts, and there was no significant change after the surgery.

Interpretation

There was no significant association among cyst volume reduction, laterality, and clinical neurocognitive function improvement. The present findings indicate a limited role for surgical intervention in improving the intellectual abilities of children with arachnoid cysts.

Keywords

Arachnoid cyst Neurocognitive profile Children 

Notes

Funding information

This research was financially supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) and by the Ministry of Health & Welfare, Republic of Korea (grant number HI12C0066).

Compliance with ethical standards

This study was approved by the institutional review board of Seoul National University Hospital.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO (2010) Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 5:578–585.  https://doi.org/10.3171/2010.2.Peds09464 CrossRefGoogle Scholar
  2. 2.
    Clemenceau S, Carpentier A (1999) Intracranial arachnoid cysts. A review. Rev Neurol 155:604–608Google Scholar
  3. 3.
    Lang W, Lang M, Kornhuber A, Gallwitz A, Kriebel J (1985) Neuropsychological and neuroendocrinological disturbances associated with extracerebral cysts of the anterior and middle cranial fossa. Eur Arch Psychiatry Neurol Sci 235:38–41CrossRefGoogle Scholar
  4. 4.
    Raeder MB, Helland CA, Hugdahl K, Wester K (2005) Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology 64:160–162.  https://doi.org/10.1212/01.Wnl.0000148724.61966.A4 CrossRefGoogle Scholar
  5. 5.
    Soukup VM, Patterson J, Trier TT, Chen JW (1998) Cognitive improvement despite minimal arachnoid cyst decompression. Brain Dev 20:589–593CrossRefGoogle Scholar
  6. 6.
    Wester K, Hugdahl K (1995) Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry 59:293–298CrossRefGoogle Scholar
  7. 7.
    Park K, Yoon J, Park H, Pakr H, Kwon K (1991) The manual of Korean educational development institute-wechsler intelligence scale for children-revised. Korean Educational Development Institute, SeoulGoogle Scholar
  8. 8.
    Bender L (1938) A visual motor gestalt test and its clinical use. Research Monographs, American Orthopsychiatric AssociationGoogle Scholar
  9. 9.
    Park YS, Eom S, Shim KW, Kim DS (2009) Neurocognitive and psychological profiles in pediatric arachnoid cyst. Childs Nerv Syst 25:1071–1076.  https://doi.org/10.1007/s00381-009-0872-0 CrossRefGoogle Scholar
  10. 10.
    Wester K (2008) Intracranial arachnoid cysts--do they impair mental functions? J Neurol 255:1113–1120.  https://doi.org/10.1007/s00415-008-0011-y CrossRefGoogle Scholar
  11. 11.
    Stowe LA, Go KG, Pruim J, den Dunnen W, Meiners LC, Paans AM (2000) Language localization in cases of left temporal lobe arachnoid cyst: evidence against interhemispheric reorganization. Brain Lang 75:347–358.  https://doi.org/10.1006/brln.2000.2358 CrossRefGoogle Scholar
  12. 12.
    Golaz J, Bouras C (1993) Frontal arachnoid cyst. A case of bilateral frontal arachnoid cyst without clinical signs. Clin Neuropathol 12:73–78Google Scholar
  13. 13.
    Choi JW, Lee JY, Phi JH, Kim SK, Wang KC (2015) Stricter indications are recommended for fenestration surgery in intracranial arachnoid cysts of children. Childs Nerv Syst 31:77–86.  https://doi.org/10.1007/s00381-014-2525-1 CrossRefGoogle Scholar
  14. 14.
    Bornstein RA (1983) Verbal IQ–performance IQ discrepancies on the Wechsler Adult Intelligence Scale-Revised in patients with unilateral or bilateral cerebral dysfunction. J Consult Clin Psychol 51:779–780CrossRefGoogle Scholar
  15. 15.
    Goldberg E, Podell K, Lovell M (1994) Lateralization of frontal lobe functions and cognitive novelty. J Neuropsychiatry Clin Neurosci 6:371–378.  https://doi.org/10.1176/jnp.6.4.371 CrossRefGoogle Scholar
  16. 16.
    Iverson GL, Woodward TS, Green P (2001) Base rates of WAIS-R VIQ-PIQ differences in 1593 psychiatric inpatients. J Clin Psychol 57:1579–1587CrossRefGoogle Scholar
  17. 17.
    Ryan JJ, Bartels JM, Morris J, Cluff RB, Gontkovsky ST (2009) WAIS-III VIQ–PIQ and VCI–POI discrepancies in lateralized cerebral damage. Int J Neurosci 119:1198–1209CrossRefGoogle Scholar
  18. 18.
    Bornstein RA, Matarazzo JD (1982) Wechsler VIQ versus PIQ differences in cerebral dysfunction: a literature review with emphasis on sex differences. J Clin Neuropsychol 4:319–334CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Pediatric NeurosurgerySeoul National University Children’s HospitalSeoulRepublic of Korea
  2. 2.Department of Neurosurgery, Seoul National University HospitalSeoul National University College of MedicineSeoulRepublic of Korea
  3. 3.Department of AnatomySeoul National University College of MedicineSeoulRepublic of Korea
  4. 4.Department of NeurosurgeryThe Armed Forces Capital HospitalSeongnamRepublic of Korea
  5. 5.Department of Psychiatry and Behavioral Science, Seoul National University Children’s HospitalSeoul National University College of MedicineSeoulRepublic of Korea

Personalised recommendations