Skip to main content

Advertisement

SpringerLink
Log in

The unique features of middle cranial fossa and Sylvian fissure arachnoid cysts in children: MRI evaluation

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

Abstract

Purpose

The purpose of the study is to evaluate MRI findings of middle fossa arachnoid cysts in children according to Galassi classification and determine the differences between types and to assess the morphological changes in cysts during follow-up imaging.

Methods

MR images of 266 middle fossa arachnoid cysts of 255 pediatric patients were evaluated by two experienced radiologists retrospectively. MRI features including the sidedness of the cyst, Galassi type, parenchymal compression findings (cortical flattening and white matter compression), bone remodeling, and midline shift were evaluated on axial T2- and T1-weighted images. Follow-up MRI and available CSF flow MR imaging data were evaluated for change in cyst size and cisternal connections, respectively.

Results

The most common type was type 1 according to Galassi classification. The accompanying bone remodeling and white matter compression had a higher incidence in Galassi type 2 and 3 groups than Galassi type 1. Mean age of patients with bone remodeling and white matter compression was significantly higher in patients with Galassi type 1. All patients with cyst enlargement were younger than 2 years of age, and all of them were Galassi type 1. Cisternal connection was demonstrated in 7 patients.

Conclusion

While parenchymal compression and bone remodeling are expected findings in Galassi type 2 and 3 cysts, these features can also be seen in smaller Galassi type 1 cysts, regardless of size. Most of the middle fossa arachnoid cysts remain stable on follow-up imaging, and the increase in size is not an expected finding, especially in older children.

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
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Availability of data and material

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

References

  1. Osborn AG, Preece MT (2006) Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology 239:650–664

    Article  PubMed  Google Scholar 

  2. Pain M, Ghatan S (2017) Arachnoid cysts in childhood. In: Winn HR (ed) Youmans and Winn neurological surgery. Elsevier Saunders, New York, pp 1524–1530

    Google Scholar 

  3. Gelabert-González M (2004) Intracranial arachnoid cysts. Rev Neurol 39:1161–1666

    PubMed  Google Scholar 

  4. Osborn AG (2004) Arachnoid cyst. In: Diagnostic imaging: brain. Salt Lake City, Utah: Amirsys, I-7–4

  5. Logan C, Asadi H, Kok HK et al (2016) Arachnoid cysts-common and uncommon clinical presentations and radiological features. J Neuroimaging Psychiatry Neurol 1:79–84

    Google Scholar 

  6. Algin O (2018) Evaluation of the communication between arachnoid cysts and neighboring cerebrospinal fluid spaces by T2W 3D-SPACE with variant flip-angle technique at 3 T. J Comput Assist Tomogr 42:816–821

    Article  PubMed  Google Scholar 

  7. Galassi E, Tognetti F, Gaist G et al (1982) CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol 17:363–369

    Article  CAS  PubMed  Google Scholar 

  8. Al-Holou WN, Yew AY, Boomsaad ZE et al (2010) Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 5:578–585

    Article  PubMed  Google Scholar 

  9. Tamburrini G, Dal Fabbro M, Del Fabbro M et al (2008) Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst 24:593–604

    Article  PubMed  Google Scholar 

  10. Jafrani R, Raskin JS, Kaufman A et al (2019) Intracranial arachnoid cysts: pediatric neurosurgery update. Surg Neurol Int 10:15

    Article  PubMed  PubMed Central  Google Scholar 

  11. Okada Y, Hamano K, Iwasaki N et al (1998) Epilepsy accompanied by intracranial arachnoid cysts: studies on volume and regional cerebral blood perfusion using MRI and SPECT. J Epilepsy 11:195–201

    Article  Google Scholar 

  12. Halani SH, Safain MG, Heilman CB (2013) Arachnoid cyst slit valves: the mechanism for arachnoid cyst enlargement. J Neurosurg Pediatr 12:62–66

    Article  PubMed  Google Scholar 

  13. Cohen MA, Cohen NA, Moonis G et al (2007) Long-term follow-up of a multiloculated arachnoid cyst of the middle cranial fossa. Ear Nose Throat J 86:338–341

    Article  PubMed  Google Scholar 

  14. Incu R, Agrawal A, Eiras J (2007) Intracranial arachnoid cysts: current concepts and treatment alternatives. Clin Neurol Neurosurg 109:837–843

    Article  Google Scholar 

  15. Schroeder HWS, Gaab MR (1997) Endoscopic observation of a slit valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery 40:198–200

    CAS  PubMed  Google Scholar 

  16. Go KG, Houthoff HJ, Blaauw EH et al (1984) Arachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg 60:803–813

    Article  CAS  PubMed  Google Scholar 

  17. Yildiz H, Erdogan C, Yalcin R et al (2005) Evaluation of communication between intracranial arachnoid cysts and cisterns with phase-contrast cine MR imaging. AJNR Am J Neuroradiol 26:145–151

    PubMed  PubMed Central  Google Scholar 

  18. Tali ET, Ercan N, Kaymaz M et al (2004) Intrathecal gadolinium enhanced MR cisternography used to determine potential communication between the cerebrospinal fluid pathways and intracranial arachnoid cysts. Neuroradiology 46:744–754

    Article  PubMed  Google Scholar 

  19. Algin O, Hakyemez B, Gokalp G et al (2009) Phase-contrast cine MRI versus MR cisternography on the evaluation of the communication between intraventricular arachnoid cysts and neighbouring cerebrospinal fluid spaces. Neuroradiology 51:305–312

    Article  PubMed  Google Scholar 

  20. Algin O, Hakyemez B, Parlak M (2011) Phase-contrast MRI and 3D-CISS versus contrast-enhanced MR cisternography for the detection of spontaneous third ventriculostomy. J Neuroradiol 38:98–104

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Seda Kaynak Sahap & Suat Fitoz

  2. Department of Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Sena Unal

Authors
  1. Seda Kaynak Sahap
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sena Unal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suat Fitoz
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Seda Kaynak Sahap and Sena Unal. The first draft of the manuscript was written by Seda Kaynak Sahap and Sena Unal, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Suat Fitoz.

Ethics declarations

Ethics approval and consent to participate

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Ankara University. Informed consent was waived due to the retrospective nature of the study.

Consent for publication

Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript.

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

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 (e.g. a society or other partner) 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

Sahap, S.K., Unal, S. & Fitoz, S. The unique features of middle cranial fossa and Sylvian fissure arachnoid cysts in children: MRI evaluation. Childs Nerv Syst 39, 79–85 (2023). https://doi.org/10.1007/s00381-022-05712-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-022-05712-3

Keywords

Search

Navigation