Management of Suprasellar Arachnoid Cysts in Children: A Systematic Literature Review Highlighting Modern Endoscopic Approaches

Kelly, Katherine A.; Sherburn, Madeleine; Sellyn, Georgina E; Ahluwalia, Ranbir; Foster, John Burt; Shannon, Chevis N.; Bonfield, Christopher M.

doi:10.1016/j.wneu.2020.05.122

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…However, the search for predictors of success and choice of the best technique are still under discussion. There is no significant difference in reductions in cystic dimensions despite the fact that cystoventriculostomy presents a higher (27)(28)(29). Explanations for the higher failure rate of the VC would be: formation of a sealing membrane in the superior fenestration after the collapse of the cyst, cystic fluid exiting through the inferior cisternal route in the VCC, presence of preoperative aqueduct stenosis that makes the relief of the apical portion of the cyst insufficient, with recurrence of hydrocephalus (53,54,58).…”

Section: Discussionmentioning

confidence: 99%

“…Those diagnosed in the prenatal period, however, disappear or stabilize without symptoms during follow-up in a significant proportion of cases (11) Although, in adults, the most common symptoms are related to increased intracranial pressure, in children the most frequent clinical presentation is macrocephaly associated with neuromotor deficit, hormonal deficiency and ocular motor nerve palsy (24). It is not expected, however, that 2)There is no difference in the reduction of cyst dimensions in VC or VCC; the difference lies in the higher rate of recurrence of the former (27). Better effectiveness does not exempt VCC from a significant rate of complications: transient VI nerve palsy, hormonal deficit and cerebral salt wasting syndrome (CSW).…”

Section: Suprasellar Arachnoid Cystsmentioning

confidence: 99%

“…Treatment of intracranial arachnoid cysts by endoscopy has been the current choice for those located in deep-seated regions, such as quadrigeminal (5)(6)(7)(8)(9) and suprasellar cysts (10,11); and is the first option for cysts of the temporal middle fossa and posterior fossa, with techniques, variations and results widely available in the specialized literature.…”

Section: Introductionmentioning

confidence: 99%

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Why neuroendoscopy is not for all supratentorial intracranial arachnoid cysts in children: analysis of risk factors and prognosis

Cavalcante

Guedes

Moreira

2022

Arch Pediat Neurosurg

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Cerebral neuroendoscopy is a minimally invasive approach that reduces brain exposure, retraction and mobilization of neural tissues and neurovascular structures and the treatment of intracranial arachnoid cysts by endoscopy has been widely used. Selection of the patients who are most likely to benefit remains challenging in certain cases. The purpose of this article is to raise questions and observations regarding its indication and failure in pediatric patients with suprasellar, and middle fossa arachnoid cysts. We searched English-language articles published in the last 20 years and found evidence that Neuroendoscopy emerged as an alternative to the treatment of this pathology and has its definitive role as a safe, less morbid strategy in these supratentorial pediatric arachnoid cysts and must be added to the therapeutic protocols respecting the best indication.

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Section: Discussionmentioning

confidence: 99%

Section: Suprasellar Arachnoid Cystsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Why neuroendoscopy is not for all supratentorial intracranial arachnoid cysts in children: analysis of risk factors and prognosis

Cavalcante

Guedes

Moreira

2022

Arch Pediat Neurosurg

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“…The most common complications of surgical treatment are recurrence, subdural hematoma, subdural hygroma, CSF leakage, intralesional and/ or intraventricular hemorrhage, seizures, wound infections, meningitis, and hormonal deficiencies (10,23). Surgical complications such as meningitis, shunt dysfunction, and cranial nerve palsy may occur in patients undergoing shunt surgery (10,43).…”

Section: Treatment Modalitiesmentioning

confidence: 99%

Intracranial arachnoid cysts

ÖZDEMİR¹,

YÜKSEL²

2022

J. Transl. Pract. Med.

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Intracranial arachnoid cysts, known as leptomeningeal cysts, are benign lesions that develop after the collections of cerebral spinal fluid (CSF) wrapped by a wall of collagen and arachnoid cells congenitally (real) or acquired (sourced by bleeding, tumor, trauma, or meningitis). Most of these cysts are asymptomatic. Symptomatic cysts are detected in the first 20 years of life, and three-quarters of these cysts become symptomatic during childhood. Typical symptoms are headache, nausea, vomiting, epilepsy, sudden loss of consciousness depending on cyst rupture or bleeding, macrocephaly, hydrocephalus, endocrinological disorders, psychiatric disorders, and focal findings of the lesion occupying space within the head (weakness, cranial neuropathy). They are usually diagnosed using radiological imaging methods including X-Ray, transfontanel ultrasonography, computed tomography, magnetic resonance imaging, and scintigraphy. Surgical treatment is not recommended for arachnoid cysts unless they cause a mass effect or symptoms and they are annually follow-up with CT or MR scan is an appropriate method in asymptomatic patients. Interestingly, no standard surgical intervention method has been recommended for the cyst. Therefore, the patient's clinical and radiological findings, age, size, and localization of the cyst are still the most important factors in the decision-making of the surgical intervention method. Surgical intervention methods include cyst resection and fenestration of the cyst into the basal cisterns by craniotomy; endoscope-assisted cyst fenestration through the burr hole; cystoperitoneal shunt or ventriculoperitoneal shunt.

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“…Subdural-peritoneal shunts are used in hygroma-associated CSF circulation disturbances and may need removal or conversion into VP shunt if hydrocephalus persists. Cystoperitoneal shunts should be avoided since almost all cysts do not represent a hydrocephalic condition but rather a problem of CSF isolated compartments, which should be broad in communication with regular CSF spaces by endoscopy or microsurgery [6,38]. Lumbar peritoneal shunts are described for circumstances of narrow ventricles but represent a rather problematic solution especially in children since frequently seen chronic over-drainage in this age group may lead to secondary Chiari Malformation with possible herniation in the long run [14].…”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Integrated understanding of hydrocephalus — a practical approach for a complex disease

Thomale

2021

Childs Nerv Syst

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Most of childhood hydrocephalus are originating during infancy. It is considered to be a complex disease since it is developed on the basis of heterogeneous pathophysiological mechanisms and different pathological conditions as well as during different age groups. Hence, it is of relevant importance to have a practical concept in mind, how to categorize hydrocephalus to surgically better approach this disease. The current review should offer further basis of discussion on a disease still most frequently seen in Pediatric Neurosurgery. Current literature on pathophysiology and classification of pediatric hydrocephalus has been reviewed to integrate the different published concepts of hydrocephalus for pediatric neurosurgeons. The current understanding of infant and childhood hydrocephalus pathophysiology is summarized. A simplified concept based on seven factors of CSF dynamics is elaborated and discussed in the context of recent discussions. The seven factors such as pulsatility, CSF production, major CSF pathways, minor CSF pathways, CSF absorption, venous outflow, and respiration may have different relevance and may also overlap for the individual hydrocephalic condition. The surgical options available for pediatric neurosurgeons to approach hydrocephalus must be adapted to the individual condition. The heterogeneity of hydrocephalus causes mostly developing during infancy warrant a simplified overview and understanding for an everyday approach. The proposed guide may be a basis for further discussion and may serve for a more or less simple categorization to better approach hydrocephalus as a pathophysiological complex disease.

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Management of Suprasellar Arachnoid Cysts in Children: A Systematic Literature Review Highlighting Modern Endoscopic Approaches

Cited by 11 publications

References 26 publications

Why neuroendoscopy is not for all supratentorial intracranial arachnoid cysts in children: analysis of risk factors and prognosis

Why neuroendoscopy is not for all supratentorial intracranial arachnoid cysts in children: analysis of risk factors and prognosis

Intracranial arachnoid cysts

Integrated understanding of hydrocephalus — a practical approach for a complex disease

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