Clinical characteristics of pediatric intracranial arachnoid cysts: an analysis of 488 cases

Abstract

Objective To summarize the clinical features of pediatric intracranial arachnoid cysts (IACs). Methods Retrospective analysis of clinical data of 488 patients with pediatric IACs, admitted to our hospital from January 2003 to September 2013, was performed; 342 males and 146 females (M:F=2.34:1, mean age=[5.61±3.25] years) were chosen. Results A total of 221 patients (45.29%) were discovered accidentally, while 267 patients (54.71%) existed clinical chief complaints, including 123 (46.07%) can be found being responsible for. A total of 364 patients (74.59%) were simple IACs, and 124 patients (25.41%) were combined with other congenital diseases. IACs located at the middle cranial fossa (n=355, 72.75%), the posterior fossa (n=82, 16.80%), the anterior cranial fossa (n=20, 4.10%), the cerebral convexity (n=12, 2.46%), the suprasellar cistern (n=7, 1.43%), the intracerebral ventricle (n=5, 1.02%), the quadrigeminal cistern (n=5, 1.02%), and the inter hemispheres (n=2, 0.41%). Four hundred and forty-nine patients (92.01%) were single cyst, and 39 (7.99%) were multiple cysts. In aspect of the tension effects based on imaging, 127 patients (26.02%) were positive, and 361 (73.98%) were negative. All 76 patients (15.57%) accepted surgical operation, and 412 (84.43%) adopted the conservative treatment. After 3-72 months follow-up (mean 32.43±8.92 months), the symptoms relieved and the volume of cysts reduced in operation cases in different degrees; while 407 patients (98.78%) were stable, 3 (0.73%) worsened on clinical symptoms, and 2 (0.49%) were improved. Conclusions The clinical complaints of IACs in children are complex, but only part could be determined the responsibility relations between the clinical complaints and IACs. Some IACs could be accompanied with other congenital diseases. In the natural history of IACs, most cysts maintain the stable volume, and only a few of IACs need operation intervention. Key words: Arachnoid cyst; Pediatry, Natural history; Clinical symptom