Fetal Arachnoid Cyst Research Articles

Fetal arachnoid cyst: characteristics, management in pregnancy, and neurodevelopmental outcomes.

Arachnoid cysts are rarely found during the prenatal period and can exist in any part of the brain as extra-axial cysts. These cysts are usually found after the second trimester and should be differentiated from other types of brain cysts and tumors using ultrasonography and magnetic resonance imaging. Serial sonographic examinations are necessary to evaluate associated central nervous system (CNS) or extra-CNS anomalies and changes in size or shape during pregnancy. If there are other associated anomalies, prenatal genetic evaluations are strongly recommended. Surgical procedures are necessary after birth in approximately 30-60% of the patients. Most isolated cysts have favorable neurodevelopmental outcomes, although information on their prognosis is limited.

Teaching Neuro Images : Giant fetal arachnoid cyst with favorable neurologic outcome

A 29-year-old woman was referred after an ultrasound at 24 weeks' gestation demonstrated a 1.8-cm intracranial cyst. Fetal MRI1 at 29 weeks (figure 1) showed a large cyst anterior to the brainstem measuring 3.4 × 1.7 cm with associated mass effect. Postnatal MRI at age 11 months (figure 2) confirmed the large suprasellar-prepontine arachnoid cyst (SPAC) with mass effect on the brainstem. Neurologic examination at age 17 months revealed no gross neurodevelopmental deficits and no intervention was required. SPACs comprise 5%–12% of arachnoid cysts and are often symptomatic, with signs of hydrocephalus or mass effect, and may require surgery.2

Rapid aneuploidy diagnosis of trisomy 18 by array comparative genomic hybridization using uncultured amniocytes in a pregnancy with fetal arachnoid cyst detected in late second trimester

Rapid aneuploidy diagnosis of trisomy 18 by array comparative genomic hybridization using uncultured amniocytes in a pregnancy with fetal arachnoid cyst detected in late second trimester

Combined intraoperative magnetic resonance imaging and navigated neuroendoscopy in children with multicompartmental hydrocephalus and complex cysts: a feasibility study

The rationale for using endoscopy to treat complex cysts and multiloculated hydrocephalus is to combine several CSF compartments into a minimum number, establish a connection to functioning CSF compartments (that is, ventricles), and decrease shunt dependency. The aim is to decrease the number of proximal shunt catheters, the number of shunt revisions, and in selected cases even to avoid a shunt. In cases of distorted anatomy and multiloculated cysts, endoscopy may be problematic because of orientation issues. Standard navigation becomes useless soon after CSF loss due to brain shift. Therefore, the concept of "real-time" navigation and intraoperative imaging in combination with endoscopic surgery has been previously suggested. The goal of the present study was to assess the feasibility and efficacy of combining intraoperative MR (iMR) imaging and navigated neuroendoscopy in infants. The authors report their experience in treating 5 infants (aged 6-14 months), who underwent surgery for multicystic hydrocephalus presenting with shunt malfunction (4 patients) and a quadrigeminal fetal arachnoid cyst (1 patient). In all infants, a low-field portable iMR imaging system (0.12-T PoleStar N-10/0.15-Tesla PoleStar N-20) was used in conjunction with navigated endoscopy. The authors used e-steady, T1-weighted, and T2-weighted sequences (acquisition time 24 seconds to 3.5 minutes). The iMR imaging system provided clear images that correlated with the endoscopic appearance of the cystic membranes in all patients, and the images were helpful in determining trajectories and redefining targets. The iMR images documented brain shift and changes in CSF spaces during surgery. There were no intraoperative complications or technical difficulties of visualization. No infection or any other immediate postoperative complication occurred. Patients were followed up for 9 months to 7 years. The infant presenting with the quadrigeminal cyst remains shunt free since surgery, and the patients with multicystic hydrocephalus have 1-2 shunts each. Following endoscopic, iMR imaging-guided surgery, shunt catheter positioning was found to be optimal and as planned according to the postoperative imaging. Navigated neuroendoscopy and iMR imaging may complement each other, offering an advantage over other modalities in complicated cases of hydrocephalus. Whenever targets and trajectories need to be redefined, the iMR images provided an updated navigation data set, allowing accurate navigation of the endoscope and minimizing the number of CSF compartments. Direct vision through the endoscope provides microanatomical details for the optimization of fenestration and catheter positioning. The combined usage of the two modalities may transform a conventional procedure into a visually controlled real-time navigated process.

Prenatal diagnosis of fetal arachnoid cyst of the quadrigeminal cistern in ultrasonography and MRI

Prenatal diagnosis of fetal arachnoid cyst of the quadrigeminal cistern in ultrasonography and MRI

1455: Combined Prenatal Ultrasound and Fetal MR Imaging in Diagnosis of Fetal Arachnoid Cyst of 2 Cases

Arachnoid cyst is accumulation of cerebrospinal fluid within the arachnoid membrane due to maldevelopment of the arachnoid or secondary to trauma or infection. Neonatal arachnoid cyst is rare, representing 1% of intracranial masses, with 50-60% occurring in the middle cranial fossa. The prognosis is generally good. However, neonatal morbidity and mortality depend on the location of the cyst and complications, such as acute mass effect by intracystic hemorrhage or the development of a subdural hygroma or hematoma.

P44.16: Combined prenatal ultrasound and fetal MR Imaging in diagnosis of fetal arachnoid cyst of 2 cases

P44.16: Combined prenatal ultrasound and fetal MR Imaging in diagnosis of fetal arachnoid cyst of 2 cases

Fetal arachnoid cyst of the quadrigeminal cistern in MRI and ultrasound

The authors report a fetus with an arachnoid cyst of the quadrigeminal cistern without hydrocephalus at 30 gestational weeks. We reviewed the literature and could find only 62 reported cases of arachnoid cyst of the quadrigeminal cistern. We present a case without hydrocephalus diagnosed by combining ultrasound (US) and magnetic resonance imaging (MRI). The fetus, born by normal delivery, was followed up and did not show hydrocephalus for 1 year. This combined prenatal study, which uses US and MRI, helps in dispensing proper counseling to parents and assists the gynecologist and the neurosurgeon in the pre- and postnatal management of this condition.

Prenatal diagnosis of a large fetal arachnoid cyst.

A case of prenatal diagnosis and management of a giant fetal arachnoid cyst is presented. The importance of an accurate diagnosis is highlighted and the use of three-dimensional ultrasound is discussed. The recent literature is reviewed.

Fetal arachnoid cyst: report of two cases.

Two new cases of antenatal diagnosis of arachnoid cyst are described. Diagnosis was made at 2.5 and 32 weeks' gestational age. In the first case, a slight increase in the diameter of the anechoic mass was observed in the second trimester. In the second case, ventricular dilatation was present prenatally. Appropriate surgical therapy was initiated at 2 months in the first case and at 8 days in the second and the neurological development of the two children is considered as normal at 18 months of age. Major features of in utero diagnosis, treatment and follow-up are discussed.