Long-term follow-up of children and juveniles with arachnoid cysts

Abstract

In the vast literature on intracranial arachnoid cysts, communication of long-term follow-up is rare. Therefore, we studied the case histories of 60 children and juveniles operated on in our hospital since 1951. The most favorable cases were patients with temporal cysts: 93% recovered fully or with only slight deficits. In other locations (frontal, parietal, occipital, infratentorial), the percentages for a favorable course were lower. The reason cannot be attributed to the operation procedures. Independent of the surgical procedure, there were no postoperative deaths after 1969. Long-term follow-up revealed that, depending on the location of the arachnoid cyst, a high percentage (62%-93% of patients) had normal physical and social development with satisfactory quality of life.

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

“…We attribute much o f our recent success in group 2 patients to more aggressive, open fenestration procedures where multiple openings in the cyst wall are best achieved, while at the same time making our cranioto mies progressively smaller. The overall 14% complication rate and the 0% mortali ty rate in our series (table 5) compare favorably to other pediatric series reported in the literature [7,15,22]. The rate o f postoperative complications declined from group 1 (16%) to group 2 (13%).…”

“…The majority o f these complications were subdural hematomas or effusions. Remarkably, 6 o f the 7 cysts which required a C P shunt due to unsuccessful fenestra tion during the second study period were located in the middle fossa, a location which usually accounts for the most favorable operative results [22], In some o f these cases the arachnoid membranes were notably thickened and may indicate previous hemorrhage into the cyst and/ or the subarachnoid space. There were no significant com plications seen in any o f the 21 patients with cysts located in the posterior fossa.…”

“…Six o f 15 patients (40%) with fenestrated cysts in the series o f 40 children reported by Ciricillo et al [15] suffered complications after surgery, while these authors reported no permanent complications in 28 pa tients undergoing shunting procedures. Richard et al [22] found in their long-term follow-up o f 60 children with arachnoid cysts that unfavorable surgical results could not be attributed to a particular surgical method, but rather to the location o f the cyst and the patient's age at the time o f operation. The best results in their series were seen in patients operated on after 6 years o f age and in those 95 Children with 102 Arachnoid Cysts Pediatr Neurosurg 1996; 25:165-173 patients with temporal cysts.…”

Endoscopic management of posterior fossa arachnoid cyst in an adult: case report and technical note

“…Patients who were operated endoscopically showed a favourable outcome, with improvement of the clinical symptoms at presentation and a decrease in the lesion size in around two-third of patients (24,33). CSF shunting can be considered as a secondline procedure because of the increased chance of shunt revision in the remaining one third of the cases.…”

Spontaneous Resolution of a Prepontine Arachnoid Cyst

“…The structure of the arachnoid cyst wall is similar to, but thicker than, normal arachnoid, and is composed of several layers of arachnoid cells reinforced by collagen fibers. Indeed, during endoscopic fenestration, coagulation probes and microscissors are often required to puncture the cyst wall [6, 41]. Spontaneous resolution would therefore likely require a weakening in the cyst wall to allow for fluid egress.…”