Skip to main content
SpringerLink
Log in

Clinical value of classification in the treatment of children with suprasellar arachnoid cysts

  • Original Article
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objective

The aim of this study is to investigate the clinical characteristics and prognostic effects of different subtypes of suprasellar arachnoid cysts (SAC) in children.

Methods

Fifty patients with primary SAC who had undergone endoscopic treatment in our department between January 2010 and December 2020 were studied retrospectively. All patients underwent endoscopic treatment after diagnosis, including ventriculocystostomy (VC) in 23 cases and ventriculocystocisternostomy (VCC) in 27 cases. All patients were followed up regularly after the operation, including head computed tomography (CT)/magnetic resonance imaging (MRI), and Evans index (EI) and frontal and occipital horn ratio (FOHR) index were measured to assess changes in cyst volume and hydrocephalus. The prognosis was evaluated comprehensively on the data of the improvement of clinical symptoms, child growth and development correlation score, and reduction of cyst volume 12 months after surgery. According to the new classification of SAC, 50 cases of children were classified into three groups in which we compared the clinical characteristics of different subtypes of the three groups. Logistic regression was used to analyze the influencing factors of prognosis.

Results

Completed success was achieved in 50 cases, including 31 cases with cyst volume reduction of more than 50% and 19 cases with cyst volume reduction of less than 50%. The median follow-up time was 55.3 months (22 ~ 113 months). According to the new classification criteria of SAC, there were 21 cases of SAC-1, 16 cases of SAC-2, and 13 cases of SAC-3. There were no statistically significant differences among the three groups in gender, birth weight, prenatal diagnosis, hydrocephalus, endocrine abnormalities, relief of postoperative symptoms, cyst wall texture, and surgical methods (P > 0.05). There was a statistically significant difference among the three groups in the change of the cyst volume and the maximum cyst diameter (P < 0.05), in which SAC-1 had the largest volume reduction, SAC-2 was more likely to cause endocrine symptoms and SAC-3 was inclined to lie in between. Multivariate logistic analysis showed that SAC classification and cyst wall texture were independent risk factors for the prognosis.

Conclusion

The clinical characteristics of different SAC subtypes are different, and SAC classification is one of the independent risk factors affecting prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. André A, Zérah M, Roujeau T, Brunelle F, Blauwblomme T, Puget S et al (2016) Suprasellar arachnoid cysts: Toward a new simple classification based on prognosis and treatment modality. Neurosurgery 78(3):370–379; discussion 9–80

  2. Al-Holou W, Yew A, Boomsaad Z, Garton H, Muraszko K, Maher C (2010) Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 5(6):578–585

    Article  PubMed  Google Scholar 

  3. Ciricillo S, Cogen P, Harsh G, Edwards M (1991) Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting. J Neurosurg 74(2):230–235

  4. Crimmins D, Pierre-Kahn A, Sainte-Rose C, Zerah M (2006) Treatment of suprasellar cysts and patient outcome. J Neurosurg Pediatr 105:107–114

    Article  Google Scholar 

  5. Oertel J, Baldauf J, Schroeder H, Gaab M (2009) Endoscopic options in children: Experience with 134 procedures. J Neurosurg Pediatr 3(2):81–89

  6. Freeman W, Barrett K, Bestic J, Meschia J, Broderick D, Brott T (2008) Computer-assisted volumetric analysis compared with ABC/2 method for assessing warfarin-related intracranial hemorrhage volumes. Nuerocrit Care 9(3):307–312

  7. Baroncini M, Kuchcinski G, Le Thuc V, Bourgeois P, Leroy H, Baille G et al (2019) Is endoscopic third ventriculostomy safe and efficient in the treatment of obstructive chronic hydrocephalus in adults? A prospective clinical and MRI study. Acta Neurochir 161(7):1353–1360

    Article  PubMed  Google Scholar 

  8. Brown T, Lalor A (2009) The movement assessment battery for children–second edition (MABC-2): a review and critique. Phys Occup Ther Pediatr 29(1):86–103

  9. Na S, Burns T (2016) Wechsler intelligence scale for children-V: Test review. Appl Neuropsychol Child 5(2):156–160

    Article  PubMed  Google Scholar 

  10. Maher C, Goumnerova L (2011) The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts J Neurosurg Pediatr 7(1):64–72

  11. Ma G, Li X, Qiao N, Zhang B, Li C, Zhang Y et al (2021) Suprasellar arachnoid cysts in adults: Clinical presentations, radiological features, and treatment outcomes. Neurosurg Rev 44(3):1645–1653

  12. Miyajima M, Arai H, Okuda O, Hishii M, Nakanishi H, Sato K (2000) Possible origin of suprasellar arachnoid cysts: Neuroimaging and neurosurgical observations in nine cases. J Neurosurg 93(1):62–67

    Article  CAS  PubMed  Google Scholar 

  13. Charalampaki P, Filippi R, Welschehold S, Conrad J (2005) Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts). J Minim Invasive Gynecol 48(5):283–288

    CAS  Google Scholar 

  14. Lee J, Lee Y, Jung H, Chong S, Phi J, Kim S et al (2017) Long-term endocrine outcome of suprasellar arachnoid cysts. J Neurosurg Pediatr 19(6):696–702

    Article  PubMed  Google Scholar 

  15. Abdolvahabi R, Mitchell J, Diaz F, McAllister J (2000) A brief review of the effects of chronic hydrocephalus on the gonadotropin releasing hormone system: Implications for amenorrhea and precocious puberty. Neurol Res 22(1):123–126

    Article  CAS  PubMed  Google Scholar 

  16. Imam A, Tawakul A, Miyajan K, Majeed Z, Buggs-Saxton C (2022) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and precocious puberty with a third ventricle arachnoid cyst. Cureus 14(2):e22182

  17. Ma G, Li X, Qiao N, Zhang B, Li C, Zhang Y et al (2021) Suprasellar arachnoid cysts: Systematic analysis of 247 cases with long-term follow-up. Neurosurg Rev 44(5):2755–2765

Download references

Author information

Author notes

  1. Heng Zhao and Liangliang Cao contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China

    Heng Zhao, Liangliang Cao, Yang Zhao, BaoCheng Wang, ShauiWei Tian & Jie Ma

Authors
  1. Heng Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liangliang Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yang Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. BaoCheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. ShauiWei Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jie Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by [Heng Zhao], [Liangliang Cao], and [Jie Ma]. The first draft of the manuscript was written by [Heng Zhao]. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jie Ma.

Ethics declarations

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhao, H., Cao, L., Zhao, Y. et al. Clinical value of classification in the treatment of children with suprasellar arachnoid cysts. Childs Nerv Syst 39, 767–773 (2023). https://doi.org/10.1007/s00381-022-05656-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-022-05656-8

Keywords

Search

Navigation