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Neuropsychological improvement after posterior fossa arachnoid cyst drainage

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An Erratum to this article was published on 19 April 2017

Abstract

Purpose

Posterior fossa arachnoid cysts (PFAC) are mostly considered as benign lesions of the cerebellum. Although many studies have shown the major role of the cerebellum in modulating movement, language, cognition, and social interaction, there are few studies on the cognitive impact and surgical decompression of PFAC.

Methods

We present the cases of two brothers successively diagnosed with PFAC and neuropsychological delay. After multidisciplinary discussion with the boys’ parents, it was decided to drain these lesions. Clinical signs, cerebral images, and neuropsychological status were assessed on admission and then 1 and 3 years after surgery.

Results

At presentation, both children had mild cerebellar signs, associated with cognitive and visual-motor impairments and academic regression. CT scans revealed retrovermian cysts, which were shunted. Post-operatively, both brothers demonstrated improved visual-motor skills and behavior. At follow-up, we observed disappearance of dysarthria and academic delay and significant improvement in cognition especially at the intelligence scale and in language. Fine motor skills had improved but remained slower than the average and writing skills appeared limited.

Conclusion

Except for PFAC which impair cerebrospinal fluid circulation or which are responsible for a significant mass effect, most PFAC are usually considered as “asymptomatic” and do not require surgical treatment. The two cases reported herein suggest that these lesions might be responsible for some associated but potentially reversible neuropsychological impairment. In the future, clinical assessment should include neuropsychological evaluation to help inform decision for surgical decompression in these children with PFAC.

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Acknowledgments

The authors are grateful to the patients’ parents for their kindness answering questionnaires. This study was presented in part at the 40th annual meeting of the International Society of Pediatric Neurosurgery, Sydney, Australia, 2012, September 9–13.

We are indebted to Nikki Sabourin-Gibbs for editing the manuscript.

Authors’ contributions

Conception and design: MLC, PP, SP

Data analysis: MLC, MP, HP, PP, SP

Editing: MLC, MP, CSR, LVD, PP, SP

Author information

Authors and Affiliations

  1. Laboratory of Memory and Cognition, Institute of Psychology, University Paris Descartes, Sorbonne Paris Cité, Paris, France

    M. L Cuny & P. Piolino

  2. CESP, University Paris-Sud, UVSQ, INSERM 1018, University Paris-Saclay, Villejuif, France

    M. L Cuny & L. Vaivre-Douret

  3. Department of Neurosurgery, Necker University Hospital, University Paris Descartes, Sorbonne Paris Cité, Paris, France

    M. L Cuny, M. Pallone, H. Piana, C. Sainte-Rose & S. Puget

  4. Department of Neuroradiology, Necker University Hospital, University Paris Descartes, Sorbonne Paris Cité, Paris, France

    N. Boddaert

  5. Department of Child-psychiatry, IMAGINE Institute, Necker University Hospital and Faculty of Medicine, University Paris Descartes, Sorbonne Paris Cité, Paris, France

    L. Vaivre-Douret

  6. Department of Pediatrics, Child development, Cochin-Port Royal University Hospitals, AP-HP, Paris, France

    L. Vaivre-Douret

  7. Inserm UMR-S894, Center of Psychiatry and Neurosciences, Paris, France

    P. Piolino

  8. University Institute of France, Paris, France

    P. Piolino

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  1. M. L Cuny
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  2. M. Pallone
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  3. H. Piana
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  8. S. Puget
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Correspondence to S. Puget.

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The authors declare no conflict of interest.

Additional information

P. Piolino and S. Puget are co-last authors.

An erratum to this article is available at http://dx.doi.org/10.1007/s00381-017-3368-3.

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Cuny, M.L., Pallone, M., Piana, H. et al. Neuropsychological improvement after posterior fossa arachnoid cyst drainage. Childs Nerv Syst 33, 135–141 (2017). https://doi.org/10.1007/s00381-016-3285-x

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