The Evaluation of Arachnoid Cyst in Childhood

Yıl 2020, , 418 - 427, 13.07.2020

Gül Deniz Coşkuner Suzan Şaylısoy , Coşkun Yarar , Kursat Çarman

https://doi.org/10.20515/otd.568473

Öz

Intracranial
arachnoid cysts are non-genetic cavities containing benign, sterile secretions
of cerebrospinal fluid surrounded by an arachnoid membrane. The prevalence of
arachnoid cysts is unknown in children. The aim of this study is to evaluate
the clinical features of children with arachnoid cysts. We retrospectively
reviewed the neuroimaging of 5360 patients aged between 1 months and 18 years,
retrospectively. 309 of these patients had arachnoid cyst. The incidence of arachnoid
cyst was 5.8%. The male/female ratio was 2: 1, and the mean age was 9.3 ± 5.0
years. The headache was the most common indication for neuroimaging. Arachnoid
cysts were most commonly found in the posterior fossa. Cyst size median was
found to be larger in patients who had headache complaints and those who had
surgery on positive physical examination (p <0.05). In our study, it was
determined that arachnoid cysts were a frequent neuroimaging finding in
pediatric patients and treatment was not required in the majority of cases. These
results, it is important to prevent unnecessary investigations and treatments.

Anahtar Kelimeler

Children, arachnoid cyst

Çocukluk Çağı Araknoid Kist Olgularının Değerlendirilmesi

Öz

İntrakraniyal araknoid
kistler iyi huylu, araknoid membranla çevrili serebrospinal sıvı benzeri steril
sekresyonlar içeren genetik olmayan kavitelerdir. Çocuklarda araknoid kist
sıklığı tam olarak bilinmemektedir. Bu
çalışmada nöroradyolojik incelemelerde araknoid kist saptanan çocuk olguların
klinik özelliklerinin değerlendirmesi amaçlanmaktadır. Çalışmada, yaşları 1
ay-18 yaş değişen 5360 hastaya 2010-2017 tarihleri arasında çekilen beyin
nörogörüntülemeleri retrospektif olarak incelendi. Bu
hastaların 309’unun incelemesinde araknoid kist saptandı. Araknoid kist sıklığı
%5,8 olarak saptandı. Erkek/kız oranı 2:1, ortalama yaş 9,3 ± 5,0 yıl  hesaplandı. En sık nörogörüntüleme endikasyonu
baş ağrısıydı. Araknoid kistler en sık posterior fossada bulunmaktaydı. Fizik muayenesinde pozitif bulgu saptanan olgularda, baş ağrısı
yakınması olanlarda, cerrahi uygulananlarda kist boyut ortancalarının daha
büyük olduğu belirlendi (p<0,05). Çalışmamız çocuk hastalarda
araknoid kistlerin sık bir nörogörüntüleme bulgusu olduğunu, olguların büyük
çoğunluğunda tedavi gerekmediği belirlenmiştir. Bu bugular gereksiz tetkik ve
tedavilerin önlenmesi açısından önemlidir.

Anahtar Kelimeler

Çocuk, Araknoid Kist, Nörogörüntüleme

Kaynakça

• 1. Wang PJ, Lin HC, Liu HM, Tseng CL, Shen YZ. Intracranial arachnoid cysts in children: related signs and associated anomalies. Pediatric Neurology. 1998;19:100–4.
• 2. Galassi E, Piazza G, Gaist G, Frank F. Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol. 1980;14:211-9. 3. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. 2013;118:222-31. 4. Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. Journal of neurosurgery Pediatrics. 2010;5:578-85.
• 5. Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol. 2005;63:550-3; discussion 3.
• 6. Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. Jama. 1999;282:36-9.
• 7. Weber F, Knopf H. Incidental findings in magnetic resonance imaging of the brains of healthy young men. J Neurol Sci. 2006;240:81-4.
• 8. Wester K. Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery. 1999;45:775-9.
• 9. Passero S, Filosomi G, Cioni R, Venturi C, Volpini B. Arachnoid cysts of the middle cranial fossa: a clinical, radiological and follow-up study. Acta neurologica Scandinavica. 1990;82:94-100.
• 10. Romner B, Egge A, Trumpy JH. Symptomatic, expansive middle cranial fossa arachnoid cyst treated by a cysto-peritoneal shunt. Case report and evaluation of treatment options. Acta neurologica Scandinavica. 1994;89:230-2.
• 11. Becker T, Wagner M, Hofmann E, Warmuth-Metz M, Nadjmi M. Do arachnoid cysts grow? A retrospective CT volumetric study. Neuroradiology. 1991;33:341-5.
• 12. Koch CA, Voth D, Kraemer G, Schwarz M. Arachnoid cysts: does surgery improve epileptic seizures and headaches?. Neurosurg Rev. 1995;18:173-81.
• 13. Yıkılmaz A. İntrakraniyal kistik lezyonlarda diffüzyon ağırlıklı manyetik rezonans görüntülemenin yeri [Tıpta Uzmanlık]: Erciyes Üniversitesi Tıp fakültesi; 2005.
• 14. Wajd N. Al-Holou, Samuel Terman, Craig Kilburg, Hugh J. L. Garton, Karin M. Muraszko, Cormac O. Maher. Prevalence and natural history of arachnoid cysts in adults. Journal of Neurosurgery. 2013;118:222-31.
• 15. Pascual-Castroviejo I, Roche MC, Martinez Bermejo A, Arcas J, Garcia Blazquez M. Primary intracranial arachnoidal cysts. Child's Nervous System. 1991;7:257-63.
• 16. Cojocaru EM, Stefanescu V. Strategic Management of Cerebral Arachnoid Cysts in Children in the Era of Globalisation. In S. Hugues, N. Cristache (eds.), Risk in Contemporary Economy 2017 (pp. 157-163). İasi, Romania: LUMEN Proceedings
• 17. Ceylan I, Er A, Akman C, Inecikli MF, Yaslı G, Korkmaz O. Çocukluk Çağı ve Adolesan Baş Ağrılarında Bilgisayarlı Tomografi Bulguları, Benign İntrakranial Patolojiler ve Sıklığı Computed Tomography Findings in Childhood and Adolescent Headache, Benign Intracranial Pathologies and Frequencies.Smyrna Tıp Dergisi. 2014;10-15
• 18. Oberbauer RW, Haase J, Pucher R. Arachnoid cysts in children: a European co-operative study. Child's Nervous System. 1992;8:281-6.
• 19. Hoffman HJ, Hendrick EB, Humphreys RP, Armstrong EA. Investigation and management of suprasellar arachnoid cysts. Journal of Neurosurgery. 1982;57:597-602.
• 20. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, Park YS, Lee SW. Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Child's Nervous System. 2000;16:111-6.
• 21. Levy ML, Wang M, Aryan HE, Yoo K, Meltzer H. Microsurgical Keyhole Approach for Middle Fossa Arachnoid Cyst Fenestration. Neurosurgery. 2003;53:1138-45.
• 22. Wester K, Svendsen F, Hugdahl K. Intracranial arachnoidal cysts Localization, gender and sidedness. Tidsskr-Nor-Laegeforen. 1999;119:4162–64.
• 23. Rabiei K. Intracranial Arachnoid Cysts Epidemiology, morphology and surgical outcome: Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg; 2016.
• 24. Ciricillo SF, Cogen PH, Harsh GR, Edwards MS. Intracranial arachnoid cysts in children. A comparison of the effects of fenestrastion and shunting. J Neurosurg Pediatr. 1991;74:230-5.
• 25. Marin-Sanabria EA, Yamamoto H, Nagashima T, Kohmura E. Evaluation of the management of arachnoid cyst of the posterior fossa in pediatric population: experience over 27 years. Child's nervous system: ChNS: official journal of the International Society for Pediatric Neurosurgery. 2007;23:535-42.
• 26. Raffel C, McComb JG. To shunt or to fenestrate: which is the best surgical treatment for arachnoid cysts in pediatric patients? Neurosurgery. 1988;23:338-42.
• 27. Fewel ME, Levy ML, McComb JG. Surgical treatment of 95 children with 102 intracranial arachnoid cysts. Pediatr Neurosurg. 1996;25:165-73.
• 28. Samuel F. Ciricillo, Philip H. Cogen, Griffith R. Harsh, Michael S. B. Edwards. Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting. Journal of Neurosurgery. 1991;74:230-5.
• 29. Robinson RG. The temporal lobe agenesis syndrome. Brain: a journal of neurology. 1964;87:87-106.
• 30. Leo JS, Pinto RS, Hulvat GF, Epstein F, Kricheff II. Computed tomography of arachnoid cysts. Radiology 1979;130:675-80.
• 31. Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. Journal of neuropathology and experimental neurology. 1981;40:61-83.
• 32. Hanieh A, Simpson DA, North JB. Arachnoid cysts; a critical review of 41 cases. Child’s Nerv Syst 1988;4:92-6.
• 33. Atalar MH, Karakuş K, Yıldız B, Şalk İ. Location, sidedness, and sex distribution of incidental intracranial arachnoid cysts in childhood: An MRI study. Cumhuriyet Medical Journal 2018;48:25-33.
• 34. Lütcherath V, Waaler PE, Jellum E, Wester K. Children with Bilateral Temporal Arachnoid Cysts may have Glutaric Aciduria Type 1 (GAT1); Operation Without Knowing that may be Harmful.2000;1025-30 p.
• 35. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery. 1997;40:483-90.
• 36. Huang D, Abe T, Kojima K, Tanaka N, Watauabe M, Ohkura A, Nishimura H, Hayabuchi N, Norbash AM. Intracystic hemorrhage of the middle fossa arachnoid cyst and subdural hematoma caused by ruptured middle cerebral artery aneurysm. AJNR Am J Neuroradiol. 1999;20:1284-6.
• 37. Inoue T, Matsushima T, Tashima S, Fukui M, Hasuo K. Spontaneous disappearance of a middle fossa arachnoid cyst associated with subdural hematoma. Surg Neurol. 1987:447-50.
• 38. Okada Y, Hamano K, Iwasaki N, Horigome Y, Enomoto T, Sato M, Ishikawa N, Takita H. Epilepsy Accompanied by Intracranial Arachnoid Cysts: Studies on Volume and Regional Cerebral Blood Perfusion Using MRI and SPECT. Journal of Epilepsy. 1998;11:195–201.
• 39. Arroyo S, Santamaria J. What is the relationship between arachnoid cysts and seizure foci ? Epilepsia 1997;38:1098-102.
• 40. Özışık HI, Bölük A, Saraç K, Kızkın S Özcan C. Temporal Araknoid Kistler, EEG Bulguları Ve Nöbet Tipleri. İnönü Üniversitesi Tıp Fakültesi Dergisi. 2005;12:163-7
• 41. Gosalakkal JA. Intracranial arachnoid cysts in children: A review of pathogenesis, clinical features, and management. Pediatr Neurology. 2002;26:93-8.
• 42. Gosalakkal JA. Intracranial arachnoid cysts in children: A review of pathogenesis, clinical features, and management. Pediatr Neurol 2002;26:93-8.
• 43. Wöber BC. Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep. 2013;17:341.
• 44. Straube A, Heinen F, Ebinger F, Von Kries R. Headache in school children: prevalence and risk factors. Deutsches Arzteblatt international. 2013;110:811-8.
• 45. Su HC, Hsieh MT, Hsu YC.Huge Arachnoid Cyst Presenting as Cough Headache 2014;23:153-4.
• 46. Edvardsson B, Persson S. Cluster headache and arachnoid cyst. SpringerPlus. 2013;2:4.
• 47. Locatelli D, Bonfanti N, Sfogliarini R, Gajno T.M, Pezzotta S. Arachnoid cysts: diagnosis and treatment. Child's Nervous System. June 1987;3:121–4.
• 48. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery. 1997;40:483-90.
• 49. Arai H, Sato K, Wachi A, Okuda O, Takeda N. Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting. Neurosurgery.1996;39:1108-12; discussion 12-3.
• 50. Aydin S, Doğan Ş, Abaş F. Konjenital Araknoid Kistler. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2002;28:37-41.
• 51. Beltramello A, Mazza C. Spontaneous disappearance of a large middle fossa arachnoid cyst. Surg Neurol. 1985; 24:181-3.