Intracranial Arachnoid Cyst in Children: Clinical Presentation and Risk Factors for Surgical Intervention

Abstract

Plain Language SummaryPediatric imaging findings of brain cysts are a common finding. Some cysts do not require surgical intervention while others may require surgery. We conducted a retrospective chart review from 2009 to 2021 on patients aged 0–21 years of age who were found to have a brain cyst on imaging reports. Our aim was to identify clinical risk factors in patients with brain cysts who underwent surgery versus those who did not. A total of 230 patients were included in the study, of which 45 (19.6%) underwent surgery. Overall, surgical patients were younger (median age 1.1 years) and had a median cyst volume larger (41.7 cm3), compared to nonsurgical patients (median age 5.9 years, volume 11.8 cm3, respectively). The most common reason to undergo initial imaging was headache for nonsurgical patients (54/185, 29.2%) while surgical patients had initial imaging due to large head size (11/45, 24.4%) or imaging carried out prenatally to 1 year of life (11/45, 24.4%). We found that cyst volume and age at diagnosis were predictors for surgical intervention. The greater the cyst volume was at initial diagnosis and the younger the patient was at time of diagnosis, the greater the odds the patient had of undergoing surgical intervention. Therefore these patients should be monitored closely for development of symptoms indicating a need for surgical intervention.