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Clinical variety and prognosis of intracranial arachnoid cysts in children

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Abstract

Arachnoid cysts (AC) occur in different intracranial locations. Management and prognosis depend on the clinical presentation and treatment guidelines do not exist. With this study, we want to demonstrate the clinical variety of arachnoid cysts in children and place a focus on outcome factors in operated cases. This retrospective study of a consecutive single unit series of children, who underwent AC surgery between January 2010 and September 2019, provides demographic, clinical, imaging data, and information about surgical treatment and outcome. Overall, 63 patients (71.4 male) underwent surgery. Mean age was 50 months (0–191). Mean follow-up was 40 months (0–121). Eighty-one percent of patients presented with symptoms/signs of raised ICP. Focal neurological deficits were present in 15.9%, headache in 11.1% of children. Galassi cysts represented the predominant type (30.2%), followed by suprasellar (14.3%), quadrigeminal (12.7%), retrocerebellar, CPA and midline (each 11.1%), and hemispheric cysts (7.9%). Endoscopic and microsurgical fenestrations were performed in 27% and 58.7%, stent or shunt insertion in 6.3%/57.9% of the cases. In 33.3% of the cases one and in 12.7%, a second reintervention became necessary. Reoperation rate was significantly higher in children < 1 year (p = 0.003). Cyst volume decreased in 85.7%. Seventy percent of the patients were symptom free, 5% suffered from headache, and 22% from developmental disorders. All focal neurological symptoms resolved. Complication rate and outcome are depending on age and cyst location. Recurrence and revision rates are significantly higher in young infants (p = 0.003). Midline cysts with CCA are associated with developmental disorders.

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Authors and Affiliations

  1. Center for Neurosurgery, Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

    Stephanie T. Jünger

  2. Department for Neurosurgery, University Medical Center Göttingen, Göttingen, Germany

    Friederike Knerlich-Lukoschus

  3. Department for Pediatric Neurosurgery, Asklepios Children´S Hospital, Sankt Augustin, Germany

    Andreas Röhrig, Jasmin Al Hourani, Sandra Kunze & Martina Messing-Jünger

  4. Department for Pediatric Radiology, Asklepios Children´S Hospital, Sankt Augustin, Germany

    Julia Eberle, Peter Oelkers & Martina Messing-Jünger

Authors
  1. Stephanie T. Jünger
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  2. Friederike Knerlich-Lukoschus
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  3. Andreas Röhrig
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  4. Jasmin Al Hourani
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  5. Sandra Kunze
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  6. Julia Eberle
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  7. Peter Oelkers
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  8. Martina Messing-Jünger
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by STJ, JE, PO, and MM-J. The first draft of the manuscript was written by STJ and MM-J. All other authors were involved in the clinical management of the cases. All authors commented on previous and actual versions of the manuscript.

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Correspondence to Martina Messing-Jünger.

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Jünger, S.T., Knerlich-Lukoschus, F., Röhrig, A. et al. Clinical variety and prognosis of intracranial arachnoid cysts in children. Neurosurg Rev 45, 3171–3178 (2022). https://doi.org/10.1007/s10143-022-01809-0

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  • DOI: https://doi.org/10.1007/s10143-022-01809-0

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