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Dirik MA, Sanlidag B. Intracranial cysts: incidental or neurodevelopmental? Childs Nerv Syst 2023; 39:775-780. [PMID: 36323954 DOI: 10.1007/s00381-022-05724-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/25/2022] [Indexed: 03/04/2023]
Abstract
OBJECTIVES Intracranial cysts are fluid-filled sacs within the brain. There is a diversity of intracranial cysts with different incidences in addition to the growing awareness about comorbidities and the consequences. The present study aimed to evaluate cystic findings in children who were admitted to the department of pediatric neurology. METHODS Children who were admitted to the Clinic of Pediatric Neurology and who had an MRI between 2016 and 2021 were evaluated. The MRI examination was performed with the pediatric epilepsy protocol. Children with primary intracranial cysts were enrolled in the study. Demographic and clinical findings were evaluated from the hospital's database and patients' files. RESULTS Among the 78 patients, 36 (46.2%) were male and 42 (53.8%) were female. The mean age was 7 ± 5.4 years. The most frequent presenting complaint was a seizure (47.4%). Approximately one-quarter (28.2%) had mental and/or motor retardation. Nine (11.5%) of the children had a neuropsychiatric diagnosis. Most of the cysts were located at the midline (41%) with the majority located extra-axial (71.8%) and supratentorial (78.2%). Arachnoid cysts were observed most frequently with a percentage of 64.1%, followed by pineal cysts (15.4%). The history of seizure, epilepsy, presence of mental retardation, and neuropsychiatric problems were evaluated according to the population ratios based on z approximation in which significantly higher rates were observed among cases with intracranial cysts. CONCLUSION Intracranial cysts should be taken into consideration for comorbid pathologies, especially in the childhood period. Early evaluation in patients with intracranial cysts for developmental delay and neuropsychiatric problems is important.
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Affiliation(s)
- Mehmet Alp Dirik
- Faculty of Medicine, Department of Radiology, Dr Suat Gunsel University, Kyrenia, North Cyprus
- Faculty of Medicine, Near East University, Nicosia, North Cyprus
| | - Burcin Sanlidag
- Pediatric Neurology, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Near East University, Nicosia, North Cyprus.
- Faculty of Medicine, Dr Suat Gunsel University, Kyrenia, North Cyprus.
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Li WC, Li ML, Ding JW, Wang L, Wang SR, Wang YY, Xiao LF, Sun T. Incontinentia pigmenti with intracranial arachnoid cyst: A case report. World J Clin Cases 2022; 10:8352-8359. [PMID: 36159532 PMCID: PMC9403704 DOI: 10.12998/wjcc.v10.i23.8352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/25/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Incontinentia pigmenti (IP) is a rare X-linked dominant genetic disorder that can be fatal in male infants. It is a disease that affects many systems of the human body. In addition to characteristic skin changes, patients may also have pathological features of the eyes, teeth, and central nervous system. Therefore, the lesions in these systems may be the first symptoms for which patients seek treatment. To date, no cases of IP complicated by intracranial arachnoid cyst (IAC) have been reported. This paper aims to report a case of IP with IAC in order to share the diagnosis and treatment experience of this rare case with other clinicians.
CASE SUMMARY An 11-year-old female patient suffered intermittent limb convulsions for five months and was sent to hospital. In the initial stage, the patient was considered to have primary epilepsy. Further investigation of the patient's medical history, physical examination and imaging examination led to the diagnosis of IP combined with intracranial space-occupying lesions, and secondary epilepsy. The patient was treated with craniotomy, and postoperative pathology revealed an IAC. The patient recovered well after craniotomy and had no obvious surgery-related complications. During the follow-up period, the patient did not have recurrent epilepsy symptoms.
CONCLUSION IP is a multi-system disease that presents with typical skin lesions at birth, but the long-term prognosis of this disease depends on the involvement of systems other than the skin, especially nervous system and ocular lesions.
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Affiliation(s)
- Wen-Chao Li
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
- Department of Neurosurgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Man-Li Li
- Department of Physiology, Sanquan College of Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Jiang-Wei Ding
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Lei Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Shu-Ren Wang
- Department of Neurosurgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Yang-Yang Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Li-Fei Xiao
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
| | - Tao Sun
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
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Cuny ML, Piolino P, Paternoster G, Piana H, Blauwblomme T, Beccaria K, Bourgeois M, Stricker S, Prodhomme J, Trousson C, Navarro B, Esnault E, Cozzo M, Abram M, James S, Boddaert N, Sainte-Rose C, Vaivre-Douret L, Puget S. Temporosylvian arachnoid cysts in children. Part 2: Postoperative neuropsychological and clinical improvement. J Neurosurg Pediatr 2022; 30:150-159. [PMID: 35594879 DOI: 10.3171/2021.11.peds21207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 11/19/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The authors' objective was to study clinical, imaging, and neuropsychological changes in children who underwent surgery for a temporal arachnoid cyst (TAC). METHODS Thirty-four children were prospectively assessed similarly at diagnosis and postoperatively (mean 14 months) with clinic visits, images, cognitive tests, and parental questionnaires on mood/behavior and executive functions. The scores were compared pre- and postoperatively for the entire cohort and individually. The scores of 25 children were also compared with a control group of 23 healthy age-matched children. Parents were administered an outcome questionnaire on average 4 years postoperatively. RESULTS The 34 children selected for surgery had signs of raised intracranial pressure (74%) and/or selective neuropsychological disorders presumably linked to cyst location (learning difficulties in 65%, cognitive difficulties in 56%, and mood/behavior difficulties in 47%). The majority of patients had a convex cyst (85%) and underwent microsurgical fenestration (85%). The TAC volume decreased ≥ 50% for 59% of children. On the Wechsler Intelligence Scale, the entire cohort significantly improved on Full Scale IQ and verbal and perceptual nonverbal indexes. Individually, nearly half of the children (47%) highly increased their scores (≥ 15 points) on at least one IQ index and 26% on at least two indexes. Language, working memory, episodic memory, and executive functions were also significantly improved. Improvements were more pronounced in patients with a preoperative heterogeneous profile with isolated lower scores and a left-sided cyst. Parental questionnaires showed reduction in anxiety, aggressiveness, social problems, and daily life executive disorders. Preschool-aged children improved significantly in language and verbal IQ, as did middle/high school-aged children in many domains. Individual analyses revealed improvement in 76% of cases. Cognitive scores were lower for patients preoperatively than for controls and were no longer significantly different postoperatively in verbal fluency, visual memory, and working memory. Four years later, 97% of parents described an improvement in their child, correlated with cognitive improvements. CONCLUSIONS Among children with a TAC, some have no clinical signs or neuropsychological difficulties, and others may show signs of raised intracranial pressure and/or specific neuropsychological disorders that impact daily life and require significant and long-lasting rehabilitation. In these cases, consideration may be given to surgical decompression. It is interesting to note that 76% of this surgically treated cohort improved regardless of the child's age, particularly in patients with selective disorders and an impact on daily life. However, a larger number of children will need to be investigated before the true benefit of such treatment can be known.
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Affiliation(s)
- Marie-Laure Cuny
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 2INSERM UMR 1018-CESP, Universités Paris-Saclay, UVSQ, Villejuif, France
- 5Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
| | - Pascale Piolino
- 4Institut universitaire de France, Paris, France
- 5Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
| | | | - Hélène Piana
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Thomas Blauwblomme
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Kévin Beccaria
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Marie Bourgeois
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Sarah Stricker
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Julie Prodhomme
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Clémence Trousson
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Béatrice Navarro
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Eglantine Esnault
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Mathilde Cozzo
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Maria Abram
- 5Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
| | - Syril James
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Nathalie Boddaert
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Christian Sainte-Rose
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
- 6Service de Neurochirurgie, Centre Hospitalier Universitaire de Fort de France, Université des Antilles, Fort-de-France, Martinique
| | - Laurence Vaivre-Douret
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 2INSERM UMR 1018-CESP, Universités Paris-Saclay, UVSQ, Villejuif, France
- 3Faculté de Médecine, Université de Paris, France
- 4Institut universitaire de France, Paris, France
| | - Stephanie Puget
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
- 6Service de Neurochirurgie, Centre Hospitalier Universitaire de Fort de France, Université des Antilles, Fort-de-France, Martinique
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Cuny ML, Vaivre-Douret L, Piana H, Blauwblomme T, Beccaria K, Paternoster G, Bourgeois M, James S, Zerah M, Prodhomme J, Esnault E, Cozzo M, Trousson C, Navarro B, Stricker S, Boddaert N, Sainte-Rose C, Piolino P, Puget S. Temporosylvian arachnoid cysts in children. Part 1: Cognitive profile of children with a temporal cyst and impact of the cyst in daily life. A prospective study in 100 consecutive children. J Neurosurg Pediatr 2022; 30:138-149. [PMID: 35594888 DOI: 10.3171/2021.11.peds21203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/19/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to determine the cognitive profile of children with a temporal arachnoid cyst (TAC) and its impact on daily life. METHODS The authors prospectively analyzed the cognitive and psychological profiles of 100 consecutive children relative to age and cyst characteristics (side, cyst size, and cyst shape: convex or nonconvex) and their outcome 4 years later. RESULTS Mean IQs were normal but with high heterogeneity on Full Scale IQ (FSIQ; range 59-150); 29% of children had at least one Wechsler index below the norm, in particular, Processing Speed and Working Memory Indexes. Impairments were observed in language for 31% of children, as well as in verbal memory (28%), visual memory (23%), executive function (21%), and visual attention (24%). Half of the children (50%) needed rehabilitation for learning difficulties, and 26% had academic difficulties. The parental questionnaire BRIEF (Behavior Rating Inventory of Executive Function) revealed significant executive dysfunctions in daily life for 22% of the children. One-third of the patients (34%) required psychotherapy for anxiety or social disorders, with higher rates in patients with a right-sided cyst and older children. Cyst size had very little neuropsychological impact. Convex cysts were significantly associated with worse performance than nonconvex cysts on all Wechsler indexes and FSIQ, and in language, verbal memory, attention, and visuospatial skills. Children with a convex cyst had significantly more executive and behavior difficulties in daily life and more psychotherapy than other children. The effect of cyst shape was independent of Galassi type and cyst side. Children with a ruptured cyst or an incidentally discovered cyst usually had a good cognitive level. Four years later, children without initial disorders remained stable, whereas those with difficulties who did not undergo surgery needed more rehabilitation and school adaptations. CONCLUSIONS This large cohort study revealed a varied profile of children with a TAC: at initial assessment, 50% had neuropsychological difficulties and needed rehabilitation and/or psychotherapy for learning or behavior difficulties, and 50% had no difficulties, which may explain the debate about this pathology. Patients with neuropsychological difficulties had a heterogeneous profile with normal intelligence but selective cognitive and/or behavior disorders that may have a long-term impact on their quality of life, particularly those with a right-sided cyst. A neuropsychological evaluation is not always necessary for a cyst discovered incidentally, but early evaluation is essential in patients with academic, learning, or psychological disorders. When assessment shows selective disorders presumably linked to cyst location, surgery may be considered, particularly for convex cysts, as this study revealed more effects in association with cyst shape than with cyst size and significantly poorer performance with a convex cyst.
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Affiliation(s)
- Marie-Laure Cuny
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 2INSERM UMR 1018-CESP, Universités Paris-Saclay, UVSQ, Villejuif, France
- 5Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
| | - Laurence Vaivre-Douret
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 2INSERM UMR 1018-CESP, Universités Paris-Saclay, UVSQ, Villejuif, France
- 3Faculté de Médecine, Université de Paris, France
- 4Institut universitaire de France, Paris, France
| | - Hélène Piana
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Thomas Blauwblomme
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Kévin Beccaria
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | | | - Marie Bourgeois
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Syril James
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Michel Zerah
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Julie Prodhomme
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Eglantine Esnault
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Mathilde Cozzo
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Clémence Trousson
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Béatrice Navarro
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Sarah Stricker
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
| | - Nathalie Boddaert
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
| | - Christian Sainte-Rose
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
- 6Service de Neurochirurgie, Centre Hospitalier Universitaire de Fort de France, Université des Antilles, Fort-de-France, Martinique
| | - Pascale Piolino
- 4Institut universitaire de France, Paris, France
- 5Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
| | - Stephanie Puget
- 1Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France
- 3Faculté de Médecine, Université de Paris, France
- 6Service de Neurochirurgie, Centre Hospitalier Universitaire de Fort de France, Université des Antilles, Fort-de-France, Martinique
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Orduna Martínez J, López Pisón J, Curto Simón B, García-Iñiguez JP, Samper Villagrasa P, Lafuente Hidalgo M. Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:157-164. [PMID: 35725217 DOI: 10.1016/j.neucie.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/14/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVE Arachnoid cysts (ACs) are relatively frequent lesions related to different neurological symptoms, being mostly incidentally diagnosed. This study aims to clarify whether AC surgery in epileptic patients is useful in their treatment. MATERIAL AND METHODS The patients registered in the database of the Neuropediatrics Section from May 1990 to August 2019 are analyzed retrospectively. Patients in whom the diagnosis of ACs and epilepsy coincide are studied. The location, size and number of ACs, neurological development, age at diagnosis, follow-up time, the performance of surgery on the cyst, evolution, anatomical relationship between brain electrical activity and location of AC, and type of epilepsy are analyzed. RESULTS After analyzing the database, we found 1881 patients diagnosed with epilepsy, of which 25 had at least one intracranial AC. In 9 of the patients, cerebral or genetic pathologies were the cause of epilepsy. Of the other 16, only 2 patients showed that the type of epilepsy and the epileptogenic focus coincided with the location of the AC; one of them was surgically treated without success, and the other one remained asymptomatic without receiving medical or surgical treatment. CONCLUSIONS Although it is necessary to design a prospective study to establish causality, the results of our research and the available literature suggest that there is no causal relationship between the presence of ACs and epilepsy. The study and treatment of these patients should be carried out in a multidisciplinary epilepsy surgery unit, without initially assuming that the AC is the cause of epilepsy.
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Affiliation(s)
| | - Javier López Pisón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
| | - Beatriz Curto Simón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
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Steyn PJ, Van den Heuvel LL. Cut it out or wait it out? Case series of middle fossa arachnoid cysts presenting with psychiatric symptoms and a discussion of the ethics of neurosurgical management. Gen Psychiatr 2022; 34:e100523. [PMID: 34970637 PMCID: PMC8685962 DOI: 10.1136/gpsych-2021-100523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/27/2021] [Indexed: 12/04/2022] Open
Abstract
Arachnoid cysts have been linked to neuropsychiatric morbidity. We describe two patients presenting with dissociative and manic symptoms believed to be associated with middle fossa arachnoid cysts. They were managed medically and remitted eventually, but symptoms were resistant. We briefly review the literature to discuss mechanisms by which cysts could cause symptoms and consider whether neurosurgical management would be appropriate. Although neurosurgery can be considered, its role is currently limited by practical and ethical considerations.
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Affiliation(s)
- Petrus Johannes Steyn
- Psychiatry, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
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7
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Martínez JO, Pisón JL, Simón BC, García-Iñiguez JP, Villagrasa PS, Hidalgo ML. Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature. Neurocirugia (Astur) 2021; 33:S1130-1473(21)00033-6. [PMID: 33875379 DOI: 10.1016/j.neucir.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/28/2021] [Accepted: 03/14/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVE Arachnoid cysts (ACs) are relatively frequent lesions related to different neurological symptoms, being mostly incidentally diagnosed. This study aims to clarify whether AC surgery in epileptic patients is useful in their treatment. MATERIAL AND METHODS The patients registered in the database of the Neuropediatrics Section from May 1990 to August 2019 are analyzed retrospectively. Patients in whom the diagnosis of ACs and epilepsy coincide are studied. The location, size and number of ACs, neurological development, age at diagnosis, follow-up time, the performance of surgery on the cyst, evolution, anatomical relationship between brain electrical activity and location of AC, and type of epilepsy are analyzed. RESULTS After analyzing the database, we found 1881 patients diagnosed with epilepsy, of which 25 had at least one intracranial AC. In 9 of the patients, cerebral or genetic pathologies were the cause of epilepsy. Of the other 16, only 2 patients showed that the type of epilepsy and the epileptogenic focus coincided with the location of the AC; one of them was surgically treated without success, and the other one remained asymptomatic without receiving medical or surgical treatment. CONCLUSIONS Although it is necessary to design a prospective study to establish causality, the results of our research and the available literature suggest that there is no causal relationship between the presence of ACs and epilepsy. The study and treatment of these patients should be carried out in a multidisciplinary epilepsy surgery unit, without initially assuming that the AC is the cause of epilepsy.
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Affiliation(s)
| | - Javier López Pisón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
| | - Beatriz Curto Simón
- Department of Pediatrics, Universitary Hospital Miguel Servet, Zaragoza, Spain
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8
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Cognition in Children with Arachnoid Cysts. J Clin Med 2020; 9:jcm9030850. [PMID: 32244990 PMCID: PMC7141502 DOI: 10.3390/jcm9030850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background: This study aims to evaluate if children with temporal arachnoid cysts (AC) have cognitive symptoms and if neurosurgery improves these. Methods: A prospective case series study including consecutive pediatric patients with temporal AC. The children underwent neuroradiology, neuroopthalmologic evaluation, and a standard electroencephalography (EEG). Additionally, a neuropsychologist performed a standardized set of evaluations, with a one-year follow-up consisting of Weschler Intelligence Scale for Children version IV (WISC-IV), FAS (for verbal fluency), Boston Naming Test (BNT, for visual naming ability) and NEPSY-II (Developmental NEuroPSYchological Assessment) for verbal memory. Results: Fifteen children, 9 boys and 6 girls, were evaluated and 11 underwent surgery. The Full Scale IQ subscore (FSIQ) improved from M = 84.8 to M = 93.0 (p = 0.005). The preoperative Verbal Comprehension Index (VCI) was in the low average range (M = 86.7), improving to a level within the average range (M = 94.7, p = 0.001). Preoperative Perceptual Speed Index (PSI) was in the below average range (M = 81.5), improving to a level within the average range (M = 92.5, p = 0.004). Conclusion: ACs are a common finding in a pediatric neurosurgical setting. Our data suggest that some temporal AC have a negative effect on general cognitive ability and that this impairment can be improved by surgery. We suggest a standardized evaluation, including comprehensive and validated neuropsychological assessment tools, to thoroughly assess symptoms as well as the postoperative outcome.
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Hall S, Smedley A, Sparrow O, Mathad N, Waters R, Chakraborty A, Tsitouras V. Natural History of Intracranial Arachnoid Cysts. World Neurosurg 2019; 126:e1315-e1320. [DOI: 10.1016/j.wneu.2019.03.087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 12/16/2022]
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