Sylvian Cistern Arachnoid Cyst - A Rare Cause of Precocious Puberty

Upadhyaya, Sunil; Nair, Rajesh; Kumar, Vinod; Shetty, Arjun

doi:10.1159/000368323

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…According to the literature, sylvian ACs may be responsible for precocious puberty, which might be improved with surgical treatment. 18 In our experience, however, ACs were not thought to be the direct cause of precocious puberty, given that there was no improvement after AC surgery. In our previous study, even in cases of suprasellar ACs, in which the influence of the AC on endocrine function seemed more likely, precocious puberty did not improve after surgery.…”

Section: Discussionmentioning

confidence: 59%

Long-term outcome of large sylvian arachnoid cysts: the role of surgery has been exaggerated

Kim

Lee

Kim

et al. 2020

Journal of Neurosurgery: Pediatrics

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OBJECTIVEThe surgical indications for some arachnoid cysts (ACs) are controversial. While surgical procedures can be effective when an AC is a definite cause of hydrocephalus or papilledema, most ACs do not cause any symptoms or signs. Some surgeons perform several procedures to treat ACs because of their large size. The purpose of this study was to compare the long-term outcomes of Galassi type III ACs between surgery and nonsurgery groups.METHODSThe medical records of 60 patients diagnosed with sylvian ACs (Galassi type III) who visited Seoul National University Children’s Hospital from July 1990 to March 2018 were analyzed. The authors compared the outcomes between those treated with surgery and those not treated with surgery.RESULTSOf the 60 patients, 27 patients had no symptoms, 19 patients had vague symptoms and signs associated with ACs, and the remaining 14 patients had definite AC-related symptoms and signs. Thirty-eight patients underwent surgery, and 22 patients underwent observation. Some operations were accompanied by complications. Among the 33 patients in the surgery group, excluding 5 with hydrocephalus or papilledema, 8 patients needed 18 additional operations. However, there were no patients in the nonsurgery group who needed surgical intervention during the follow-up period (mean 67.5 months), although the size of the AC increased in 2 patients. Changes in AC size were not correlated with symptom relief.CONCLUSIONSWhen patients with hydrocephalus or papilledema were excluded, there was no difference in the outcomes between the surgery and nonsurgery groups regardless of the size of the sylvian AC. Surgeons should be cautious when deciding whether to operate.

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Section: Discussionmentioning

confidence: 59%

Long-term outcome of large sylvian arachnoid cysts: the role of surgery has been exaggerated

Kim

Lee

Kim

et al. 2020

Journal of Neurosurgery: Pediatrics

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“…The causes for central precocious puberty (CPP) include hypothalamic hamartomas, postencephalitic scars, tubercular meningitis, head trauma, hydrocephalus, tuberous sclerosis, porencephaly, and suprasellar space-occupying lesions, including arachnoid cysts. 6) Additionally, patients with Arnold-Chiari malformations with myelomeningocele have been reported in some studies. 7) 8) However, reports concerning patients with Chiari type 1 malformations and precocious puberty are rare.…”

Section: Discussionmentioning

confidence: 99%

A Case of a Girl with Arnold-Chiari Type 1 Malformation with Precocious Puberty

2018

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A small percentage of individuals have the neurological anomaly of central precocious puberty (CPP). Common neurologic causes of CPP include a tumor or congenital lesions. Although Arnold-Chiari malformation can be caused by congenital or acquired causes, it is unusual in patients with CPP. We present the case of a girl aged 4.5 years who complained of breast budding. Her neurological examination and growth pattern were normal. She had no endocrinological abnormality, except for true precocious puberty. We performed brain magnetic resonance imaging, which showed an Arnold-Chiari type 1 malformation. Currently, this case represents the youngest girl who exhibited both Arnold-Chiari type 1 malformation and precocious puberty. Furthermore, it is likely that there is a meaningful association between the brain lesion and precocious puberty in this case.

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“…We read with great interest the article by Upadhyaya et al [1] entitled ‘Sylvian Cistern Arachnoid Cyst - A Rare Cause of Precocious Puberty' published in a recent issue of Pediatric Neurosurgery . It reported the case of a 3-year-old girl with a sylvian cistern arachnoid cyst presenting with precocious puberty (PP).…”

mentioning

confidence: 99%