Pediatric Neurosurgery
Observation of therapeutic effect of surgical treatment of ruptured intracranial arachnoid cyst in children
Dong Fangyong, Xu Yu, Guo Zhongyin, Chen Zirong, Peng Peng, Zhang Xiaolin, Wan Feng
Published 2022-06-28
Cite as Chin J Neurosurg, 2022, 38(6): 576-579. DOI: 10.3760/cma.j.cn112050-20220226-00116
Abstract
ObjectiveTo explore the surgical method, effectiveness and prognosis of surgical treatment of ruptured intracranial arachnoid cysts (IACs) in children.
MethodsThe clinical and imaging data of 8 children with ruptured IACs who underwent surgical treatment in the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2012 to September 2019 were retrospectively analyzed. The male/female ratio was 7/1 and the age ranged from 5.5 to 18.0 years. All arachnoid cysts in the series were located in the middle cranial fossa (left side: 5 cases, right side: 3 cases). The cysts in five patients were classified as Galassi Ⅲ with an average diameter of 6.2 cm, and three patients had Galassi Ⅱ cysts with an average diameter of 3.9 cm. All patients had symptoms of intracranial hypertension before surgery. Subdural drilling and drainage were performed in 4 cases, and craniotomy and cystectomy was performed in 4 cases. The outcomes of the patients were documented.
ResultsAll 8 patients underwent smooth operations. Among the children, one receiving burr hole drainage and one receiving craniotomy and cystectomy underwent emergency hematoma evacuation due to postoperative acute epidural hematoma, and none of the children had newly-developed neurological deficit after operation. The mean follow-up time of the 8 patients after operation was 53 months (22-110 months). The clinical symptoms were significantly relieved, and there were no positive findings in the nervous system examination, and the children could live and study normally. Imaging follow-up showed that the cysts of 4 children were significantly reduced compared with those before operation (reduced by 60%-90%), and the cysts of 4 cases had no significant changes compared with those before operation (2 cases in the drilling and drainage group and 2 cases in the group of craniotomy and cystectomy). None of the children needed to undergo shunt surgery again during follow-up.
ConclusionIndividualized surgical treatment of children with ruptured IACs is generally safe and has a good prognosis.
Key words:
Arachnoid cysts; Rupture; Child; Neurosurgical procedures; Treatment outcome
Contributor Information
Dong Fangyong
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Xu Yu
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Guo Zhongyin
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Chen Zirong
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Peng Peng
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Zhang Xiaolin
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Wan Feng
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
