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Cognitive dysfunction and subjective symptoms in patients with arachnoid cyst before and after surgery

  • Original Article - CSF Circulation
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A Correction to this article was published on 29 January 2020

This article has been updated

Abstract

Introduction

Arachnoid cysts are congenital, benign lesions in the brain and are often incidental radiological findings. Frequently, the arachnoid cysts are left untreated; however, recent studies have shown that arachnoid cysts can cause cognitive dysfunction that affect quality of life. Moreover, the function can improve after surgical decompression. Hence, there is controversy regarding symptomatology and treatment effects of arachnoid cysts. The aim of the study was to analyse if arachnoid cysts can cause cognitive impairment and subjective symptoms and if these impairments are reversible after surgical treatment.

Material and methods

Twenty-one consecutive patients with radiologically confirmed supratentorial arachnoid cysts were cognitively evaluated using a battery of seven neuropsychological tests. Twelve of these patients underwent surgery and were evaluated before and after surgery. The patients were also evaluated with neuropsychological testing after surgery. Further information was extracted from the medical records. The cognitive test results were compared to standard population values using z-test, and the test results from the surgically treated patients were compared before and after surgery using paired t-test.

Results

The surgically treated patients had a statistically significant improvement of neurocognitive test results after surgery in six out of the seven tests (p < 0.05). The total patient group showed lower mean values in all tests when compared to standard population. Statistical significance was, however, only detected in two of the seven tests. All surgically treated patients reported diminished symptoms after surgery.

Conclusions

The patients with arachnoid cysts presented with cognitive dysfunction compared to the normal population which improved after surgical decompression. Arachnoid cysts should not be considered asymptomatic unless thoroughly evaluated with clinical and neuropsychological work-up.

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Change history

  • 29 January 2020

    Incorrect family name of Åsa Bergendal.

Abbreviations

CSF:

cerebrospinal fluid

ICP:

intracranial pressure

BNT:

Boston naming test

COWA:

controlled oral word association test

SRB:

synonyms, reasoning and block design test

MMT:

mini mental test

RCF:

Rey-Osterrieth complex figure test

SD:

standard deviate

References

  1. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO (2013) Prevalence and natural history of arachnoid cysts in adults. J Neurosurg 118:222–231

    Article  PubMed  Google Scholar 

  2. Bannister CM, Russell SA, Rimmer S, Mowle DH (1999) Fetal arachnoid cysts: their site, progress, prognosis and differential diagnosis. Eur J Pediatr Surg 9(Suppl 1):27–28

    Article  PubMed  Google Scholar 

  3. Barry D, Bates ME, Labouvie E (2008) FAS and CFL forms of verbal fluency differ in difficulty: a meta-analytic study. Appl Neuropsychol 15:97–106

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bigler ED (2014) Magnetic resonance imaging in the evaluation of cognitive function. Pediatr Blood Cancer 61:1724–1728

    Article  PubMed  Google Scholar 

  5. Crum RM, Anthony JC, Bassett SS, Folstein MF (1993) Population-based norms for the mini-mental state examination by age and educational level. JAMA. 269:2386–2391

    Article  CAS  PubMed  Google Scholar 

  6. Manual til Düreman-Sälde test. Dureman I, Eriksson U-B, Kebbon L, Österberg E. Skandinaviska testförlaget, Stockholm 1971 (OCLC 186181233)

  7. Eskandary H, Sabba M, Khajehpour F, Eskandari M (2005) Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol 63:550–553

    Article  PubMed  Google Scholar 

  8. Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  9. Gosalakkal JA (2002) Intracranial arachnoid cysts in children: a review of pathogenesis, clinical features, and management. Pediatr Neurol 26:93–98

    Article  PubMed  Google Scholar 

  10. Helland CA, Wester K (2006) A population-based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in children. J Neurosurg 105(5 Suppl):385–390

    PubMed  Google Scholar 

  11. Helland CA, Wester K (2007) A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults. J Neurol Neurosurg Psychiatry 78:1129–1135

    Article  PubMed  PubMed Central  Google Scholar 

  12. Helland CA, Wester K (2007) Intracystic pressure in patients with temporal arachnoid cysts: a prospective study of preoperative complaints and postoperative outcome. J Neurol Neurosurg Psychiatry 78:620–623

    Article  PubMed  Google Scholar 

  13. Katzman GL, Dagher AP, Patronas NJ (1999) Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA. 282:36–39

    Article  CAS  PubMed  Google Scholar 

  14. Lezak MD, Howieson DB, Bigler ED, Tranel D (2012) Neuropsychological assessment, 5th edn. Oxford University Press, New York

    Google Scholar 

  15. B Gjerde P, Schmid M, Hammar A, Wester K (2013) Intracranial arachnoid cysts: impairment of higher cognitive functions and postoperative improvement. J Neurodev Disord 5:21–27

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rabiei K, Jaraj D, Marlow T, Jensen C, Skoog I, Wikkelsø C (2016) Prevalence and symptoms of intracranial arachnoid cysts: a population-based study. J Neurol 263:6896-94

    Article  Google Scholar 

  17. Raeder MB, Helland CA, Hugdahl K, Wester K (2005) Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology. 64:160–162

    Article  PubMed  Google Scholar 

  18. Shin MS, Park SY, Park SR, Seol SH, Kwon JS (2006) Clinical and empirical applications of the Rey-Osterrieth complex figure test. Nat Protoc 1:892–899

    Article  PubMed  Google Scholar 

  19. Starkman SP, Brown TC, Linell EA (1958) Cerebral arachnoid cysts. J Neuropathol Exp Neurol 17:484–500

    Article  CAS  PubMed  Google Scholar 

  20. Tomaszewki Farias S, Harrington G, Broomand C, Seyal M (2005) Differences in functional MR imaging activation patterns associated with confrontation naming and responsive naming. AJNR Am J Neuroradiol 26:2492–2499

    PubMed  PubMed Central  Google Scholar 

  21. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP (2007) Incidental findings on brain MRI in the general population. N Engl J Med 357:1821–1828

    Article  CAS  PubMed  Google Scholar 

  22. Wester K, Hugdahl K (1995) Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry 59:293–298

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Wester K, Hugdahl K (2003) Verbal laterality and handedness in patients with intracranial arachnoid cysts. J Neurol 250:36–41

    Article  PubMed  Google Scholar 

  24. Wester K (1992) Gender distribution and sidedness of middle fossa arachnoid cysts: a review of cases diagnosed with computed imaging. Neurosurgery. 31:940–944

    Article  CAS  PubMed  Google Scholar 

  25. Wester K (1999) Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery. 45:775–779

    Article  CAS  PubMed  Google Scholar 

  26. Wester K (2008) Intracranial arachnoid cysts--do they impair mental functions? J Neurol 255:1113–1120

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, St Göran Hospital, S:t Göransplan 1, 112 81, Stockholm, Sweden

    Louiza Agopian-Dahlenmark

  2. Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Tiit Mathiesen

  3. Institute of Clinical Medicine, University of Copenhagen, 2300, Copenhagen, Denmark

    Tiit Mathiesen

  4. Department of Clinical Neuroscience, Karolinska Institutet, 171 76, Stockholm, Sweden

    Tiit Mathiesen & Åsa Bergendal

Authors
  1. Louiza Agopian-Dahlenmark
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  2. Tiit Mathiesen
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  3. Åsa Bergendal
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Correspondence to Tiit Mathiesen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional- and national research committee (Swedish Ethical Review Authority) and with the 1964 Helsinki declaration and its later amendments. For this type of study, “a clinical quality assurance”, formal consent is not required. Yet, informed consent was obtained from all individual participants included in the study.

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The original version of this article was revised. The name of Åsa Bergendal is now corrected.

This article is part of the Topical Collection on CSF Circulation

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Agopian-Dahlenmark, L., Mathiesen, T. & Bergendal, Å. Cognitive dysfunction and subjective symptoms in patients with arachnoid cyst before and after surgery. Acta Neurochir 162, 1041–1050 (2020). https://doi.org/10.1007/s00701-020-04225-9

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  • DOI: https://doi.org/10.1007/s00701-020-04225-9

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