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The treatment of large supratentorial arachnoid cysts in infants with cyst-peritoneal shunting and Hakim programmable valve

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Abstract

Objective.

This retrospective case series examines 7 infants with large supratentorial arachnoid cysts who underwent cyst-peritoneal shunting and insertion of a Hakim programmable valve. Comparing pre- and postoperative clinical data, neuroradiological and regional cerebral blood flow (rCBF) findings we evaluated the efficacy of the surgical procedure.

Methods.

Infants, ranging in age from 1 to 55 days (mean age 29.5 days), were assessed pre- and postoperatively by neurological examination, developmental profile and neuroimaging.

Results.

Post procedure, all patients showed a significant reduction in the cyst/brain ratio on neuroimaging (p<0.001), 6 had a normal developmental profile (p<0.001) and 5 cases showed a significant amelioration of clinical symptoms and neurological signs. Two patients underwent preoperative SPECT scans, which showed hypoperfusion in the area surrounding the cyst; this decreased rCBF also improved post shunting.

Conclusions.

Large supratentorial arachnoid cysts in infants can be successfully treated with cyst-peritoneal shunting and insertion of a Hakim programmable valve. This is the first study specifically aimed at evaluating the long-term results of these conditions.

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Fig. 1A–C.
Fig. 2A–F.
Fig. 3A, B.

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Authors and Affiliations

  1. Neurosurgical Clinic A.O.U., University of Messina, "Policlinico G. Martino", Via Consolare Valeria, 1, 98168, Messina, Italy

    Antonino Germanò, Gerardo Caruso, Mariella Caffo, Amedeo Calisto, Francesco Meli & Francesco Tomasello

  2. Nuclear Medicine, University of Messina, "Policlinico G. Martino", Via Consolare Valeria, 1, 98168, Messina, Italy

    Sergio Baldari

Authors
  1. Antonino Germanò
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  2. Gerardo Caruso
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  3. Mariella Caffo
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  4. Sergio Baldari
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  5. Amedeo Calisto
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  6. Francesco Meli
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  7. Francesco Tomasello
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Correspondence to Antonino Germanò.

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The authors have no financial interest in the Codman Hakim programmable valve discussed in this report

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Germanò, A., Caruso, G., Caffo, M. et al. The treatment of large supratentorial arachnoid cysts in infants with cyst-peritoneal shunting and Hakim programmable valve. Childs Nerv Syst 19, 166–173 (2003). https://doi.org/10.1007/s00381-002-0702-0

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  • DOI: https://doi.org/10.1007/s00381-002-0702-0

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