Abstract
The data on arachnoid cysts in children (0–15 years) operated upon between 1980 and 1988 were analysed in a retrospective, co-operative study. The results from 285 patients indicate a predominance of these lesions in boys (64%) more than girls (36%) and a mean age of 6 years at onset of symptoms. Focal EEG patterns corresponding to the cyst's location were encountered in 32%. About 40% of all cysts were located along the midline, the sylvian fissure representing the predominant location. Open surgery, i.e. total excision or marsurpialization (together 43.3%), emerged as the first-choice surgical procedure. The type of surgery switched somewhat to shunting procedures in cases of lesions in deeper locations (22.8%). Morphological results on follow-up revealed a reduction of the size of the cyst in a significant majority (61%); in 18% the cyst had disappeared completely on CT scans. There was an obvious correlation between postoperative morphological findings and clinical outcome.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Abbott WD (1933) Cystic arachnoiditis. J Iowa Med Soc 23:315–317
Aicardi J, Bauman F (1975) Supratentorial extracerebral cysts in infants and children. J Neurol Neurosurg Psychiatry 38:57–68
Anderson FM, Segall HD (1982) Intracranial arachnoid cysts. In: Section of Pediatric Neurosurgery of the American Association of Neurological Surgeons (ed) Pediatric neurosurgery. Grune & Stratton, New York, pp 111–120
Anderson FM, Segall HD, Caton WL (1979) Use of computerized tomography scanning in supratentorial arachnoid cysts. A report on 20 children and four adults. J Neurosurg 50:333–338
Archer CR, Darwish H, Smith K Jr (1978) Enlarged cisternae magnae and posterior fossa cysts simulating Dandy-Walker syndrome on computed tomography. Radiology 127:681–686
Auer LM, Gallhofer B, Ladurner G, Sager W-D, Heppner F, Lechner H (1981) Diagnosis and treatment of middle fossa arachnoid cysts and subdural hematomas. J Neurosurg 54:366–369
Billroth T (1869) Über akute Meningitis serosa und akutes Hirnödem nach chirurgischen Operationen. Wien Med Wochenschr 19:1–7
Bret J, Benes V (1987) Diagnostic-therapeutic ventriculocystostomy. Child's Nerv Syst 3:178–179
Bright R (1831) Reports of medical cases selected with a view of illustrating the symptoms and cure of diseases by a reference to morbid anatomy, vol 2. In: Longman, Rees, Orme, Brown, Green (eds) Diseases of the brain and nervous system. London, pp 437–439
Cappelen J, Unsgaard G (1986) Arachnoid cysts of the middle cranial fossa and traumatic complications. Child's Nerv Syst 2:225–227
Choux M, Raybaud C, Pinsard N, Hassoun J, Gambarelli D (1978) Intracranial supratentorial cysts in children excluding tumor and parasitic cysts. Child's Brain 4:15–32
Cilluffo JM, Onofrio BM, Miller RH (1983) The diagnosis and surgical treatment of intracranial arachnoid cysts. Acta Neurochir (Wien) 67:215–229
Cullis PA, Gilroy J (1983) Arachnoid cyst with rupture into the subdural space. J Neurol Neurosurg Psychiatry 46:454–456
Danzinger J, Bloch S (1975) Paracollicular arachnoid pouches. Am J Roentgenol Rad Ther Nucl Med 124:310–313
Demel R (1923) Die Meningitis serosa circumscripta cerebralis unter dem Bilde des Hirntumors und ein Beitrag zu ihrer Ätiologie. Arch Klin Chir 125:561–577
Di Rocco C, Caldarelli M, Di Trapani G (1981) Infratentorial arachnoid cysts in children. Child's Brain 8:119–133
Dyck P, Gruskin P (1977) Supratentorial arachnoid cysts in adults. Arch Neurol 34:276–279
Findler G, Hoffman HJ (1980) Intracranial midline cyst in association with myelodysplasia. Neurosurgery 7:521–524
Frazier CH (1930) Cerebral pseudotumors. Arch Neurol Psychiatry 24:1117–1132
Friede RL, Yasargil G (1977) Supratentorial intracerebral epithelial (ependymal) cysts: review, case reports, and fine structure. J Neurol Neurosurg Psychiatry 40:127–137
Galassi E, Piazza G, Gaist G, Frank F (1980) Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol 14:211–219
Galassi E, Tognetti F, Gaist G, Tagioli L, Frank F, Frank G (1982) CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa. Classification and pathophysiological aspects. Surg Neurol 17:363–369
Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G (1985) Infratentorial arachnoid cysts. J Neurosurg 63:210–217
Geissinger JD, Kohler WC, Robinson BW, Davis FM (1978) Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol 10:27–33
Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J (1984) A rachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg 60:803–813
Gonzalez CA, Villarejo FJ, Blazquez MG, Castroviejo IP, Higueras AP (1982) Suprasellar arachnoid cysts in children. Report of three cases. Acta Neurochir (Wien) 60:281–296
Handa H, Bucy PC (1956) Benign cysts of the brain simulating brain tumor. J Neurosurg 13:489–499
Handa J, Nakano Y, Heihachiro A (1977) CT cisternography with intracranial arachnoid cysts. Surg Neurol 8:451–454
Hanieh A, Simpson DA, North JB (1988) Arachnoid cysts: a critical review of 41 cases. Child's Nerv Syst 4:92–96
Harsh GR, Edwards MSB, Wilson CB (1986) Arachnoid cysts in children. J Neurosurg 64:835–842
Hayashi T, Anegawa S, Honda E, et al (1979) Clinical analysis of arachnoid cysts in the middle fossa. Neurochirurgia 22:201–210
Heimans JJ, Duinen MTA van, Drift JHA van der (1979) Arachnoid cysts in the middle cranial fossa. Clin Neurol Neurosurg 81:291–300
Hoffman HJ, Hendrick EB, Humphreys RP, Armstrong EA (1982) Investigation and management of suprasellar arachnoid cysts. J Neurosurg 57:597–602
Iglesias JR, Sanjuanbenito L, Martinez-Cubells J, Lousa M, Redondo C (1981) Intracerebral arachnoid cyst containing choroid plexus. Case report. Acta Neurochir (Wien) 58:229–234
Jones RFC, Warnock TH, Nayanar V, Gupta JM (1989) Suprasellar arachnoid cysts: management by cyst wall resection. Neurosurgery 25:554–561
Locatelli D, Bonfanti N, Sfogliarini R, Gajno TM, Pezzotta S (1979) Arachnoid cysts: diagnosis and treatment. Child's Nerv Syst 3:121–124
Kars Z, Kilic K, Özgen T, Bertan V, Erbengi A (1986) Mega cistern magna: a constant variation of the cerebellomedullary cistern associated with cerebral atrophy. Neurochirurgie 29:114–116
Kato M, Nakada Y, Ariga N, Kokubo Y, Makino H (1980) Prognosis of four cases of primary middle fossa arachnoid cyst in children. Child's Brain 7:195–204
Korosue K, Tamaki N, Fujiwara K, Matsumoto S (1983) Arachnoid cyst of the fourth ventricle manifesting normal pressure hydrocephalus. Neurosurgery 12:108–110
Kumagai M, Sakai N, Yamada H, Shinoda J, Nakashima T (1986) Postnatal development and enlargement of primary middle cranial fossa arachnoid cyst recognized on repeat CT scans. Child's Nerv Syst 2:211–215
LaCour F, Trevor R, Carey M (1978) Arachnoid cyst and associtated subdural hematoma. Arch Neurol 35:84–89
Lang C, Ott G, Reichwein J, Huk W (1986) Zur klinischen Bedeutung von Arachnoidalzysten. Nervenarzt 57:619–623
Lee BCP (1979) Intracranial cysts. Radiology 130:667–674
Lesoin F, Dhellemmes P, Rousseaux M, Jomin M (1983) Arachnoid cysts and head injury. Acta Neurochir (Wien) 69:43–51
Little JR, Gomez MR, MacCarty CS (1973) Infratentorial arachnoid cysts. J Neurosurg 39:380–386
Locatelli D, Bofanti N, Sfogliarini R, Gajno TM, Pezzotta S (1987) Arachnoid cysts: diagnosis and treatment. Child's Nerv Syst 3:121–124
Marinov M, Undjian S, Wetzka P (1989) An evaluation of the surgical treatment of intracranial arachnoid cysts in children. Child's Nerv Syst 5:177–183
Mayr U, Aichner F, Bauer G, Mohsenipour I, Pallua A (1982) Supratentorial extracerebral cysts of the middle cranial fossa. Neurochirurgia 25:51–56
McCullough DC, Harbert JC, Manz HJ (1980) Large arachnoid cyst at the cranial base. Neurosurgery 6:76–81
Milhorat TH (1978) Benign intracranial cysts. In: Milhorat TH (ed) Pediatric neurosurgery. (Contemporary neurology, vol 16) Davis, Philadelphia, pp 191–209
Okonek G (1983) Extracerebrale Arachnoidalcyste der linken Großhirnhemisphäre. Zentralbl Neurochir 2:112–119
Powers SK (1986) Fenestration of intraventricular cysts using a flexible, steerable endoscope and the argon laser. Neurosurgery 18:637–641
Quain R (1855) Large cyst from the cavity of the arachnoid. Trans Pathol Soc London 6:8–10
Raimondi AJ, Shimoji T, Gutierrez FA (1980) Suprasellar cysts: surgical treatment and results. Child's Brain 7:57–72
Rengachary SS, Watanabe I (1981) Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol 40:61–83
Richard KE, Dahl K, Sanker P (1989) Long-term follow-up of children and juveniles with arachnoid cysts. Child's Nerv Syst 5:184–187
Robinson RG (1964) The temporal lobe agenesis syndrome. Brain 87:87–106
Robinson RG (1971) Congenital cysts of the brain: arachnoid malformations. Prog Neurol Surg 4:133–174
Rock JP, Zimmermann R, Bell WO, Fraser RAR (1986) Arachnoid cysts of the posterior fossa. Neurosurgery 18:176–179
Rossitch E Jr, Oakes WJ (1989) Klüver-Bucy syndrome in a child with bilateral arachnoid cysts: report of a case. Neurosurgery 24:110–112
Rousseaux M, Dhellemmes P, Clarisse J, Devos P (1982) Les kistes et les pseudokistes arachnoidiens sous, retro et supracerebelleux de l'altude. Six observations. Neurochirurgie (Paris) 28:245–253
Schranz D (1933) Über einen Fall von hochgradiger, symptomloser Gehirndeformität, durch eine Meningealcyste verursacht. Frankf Z Pathol 46:252–256
Serlo W, Wendt L v, Heikkinen E, Saukkonen AL, Heikkinen E, Nyström S (1985) Shunting procedures in the management of intracranial cerebrospinal fluid cysts in infancy and childhood. Acta Neurochir (Wien) 76:111–116
Seur NH, Kooman A (1976) Arachnoid cyst of the middle fossa with paradoxical changes of the bony structures. Neuroradiology 12:177–183
Shabo AL, Maxwell DS (1968) The morphology of the arachnoid villi: a light and electron microscopic study in the monkey. J Neurosurg 29:451–463
Shaw CM, Alvord EC Jr (1977) “Congenital arachnoid” cysts and their differential diagnosis. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 31. North-Holland, Amsterdam New York Oxford, pp 75–136
Shuangshoti S (1978) Calcified congenital arachnoid cyst with heterotopic neuroglia in wall. J Neurol Neurosurg Psychiatry 41:88–94
Smith RA, Smith WA (1976) Arachnoid cysts of the middle cranial fossa. Surg Neurol 5:246–252
Spaziante R, Cirillo S, Constans JP, Divitiis E de, Donzelli R, Stella L (1986) Arachnoid cyst of the quadrigeminal cistern. Neurochirurgia 29:117–123
Sprung C, Mauersberger W (1979) Value of computed tomography for the diagnosis of arachnoid cysts and assessment of surgical treatment. Acta Neurochir (Wien) Suppl 28:619–626
Spurling RG (1928) Chronic cystic arachnoidits. A clinical study. South Med J 21:804–811
Starkman SP, Brown TC, Linell EA (1958) Cerebral arachnoid cysts. J Neuropathol Exp Neurol 17:484–500
Starshak RJ, Meyer GA, Chio SK, Sty JR, Kovnar EA, Dunn DK (1986) Arachnoid cyst of the collicular cistern. Child's Nerv Syst 2:144–148
Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8:647–650
Tamas LB, Wyler AR (1985) Intracranial mucocele mimicking arachnoid cyst: case report. Neurosurgery 16:85–86
Taveras JM, Ransohoff J (1953) Leptomeningeal cysts of the brain following trauma with erosion of the skull. J Neurosurg 10:233–241
Tiberin P, Gurszkiewicz J (1961) Chronic arachnoidal casts of the middle cranial fossa and their relation to trauma. J Neurol Neurosurg Psychiatry 24:86–91
Van der Meche FGA, Braakman R (1983) Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms. J Neurol Neurosurg Psychiatry 46:1102–1107
Vaquero J, Carrillo R, Cabezudo JM, et al (1981) Arachnoid cysts of the posterior fossa. Surg Neurol 16:117–121
Varma TRK, Sedzimir CB, Miles JB (1981) Post-traumatic complications of arachnoid cysts and temporal lobe agenesis. J Neurol Neurosurg Psychiatry 44:29–34
Von Wild K, Gullotta F (1987) Arachnoid cyst of the middle cranial fossa — aplasia of temporal lobe? Child's Nerv Syst 3:232–234
Ware CE (1858) Cysts from the cavity of the arachnoid. Boston Med Surg J 59:259
Williams B, Guthkelch AN (1974) Why do central arachnoid pouches expand? J Neurol Neurosurg Psychiatry 37:1085–1092
Wolpert SM, Scott RM (1981) The value of metrizamide CT cisternography in the management of cerebral arachnoid cysts. AJNR 2:29–35
Yamanouchi Y, Someda K, Oka N (1986) Spontaneous disappearance of middle fossa arachnoid cyst after head injury. Child's Nerv Syst 2:40–43
Zehnder M (1938) Subarachnoidalcysten des Gehirns. Zentralbl Neurochir 2:100–112
Author information
Authors and Affiliations
Additional information
M. Colangelo, Department of Neurosurgery, Naples. Italy; L. Cristante and H.-D. Hermann, Department of Neurosurgery, Hamburg, FRG; C. Di Rocco, M. Caldarelli, and A. Ceddia, Department of Neurosurgery, Rome, Italy; J. Haase, Department of Neurosurgery, Aalborg, Denmark; A. D. Hockley, Department of Neurosurgery, Birmingham, UK; G. Kaiser, Department of Pediatrics, Bern, Switzerland; E. Kraus and H.-P. Jensen, Department of Neurosurgery, Kiel, FRG; M. Lange and R. Oeckler, Department of Neurosurgery, Munich, FRG; R. Lorenz, K. Franz, and J. Seeger, Department of Neurosurgery, Frankfurt/M., FRG; M. Marinov, Department of Neurosurgery, Sofia, Bulgaria; G. Mittermaier, Department of Pediatrics, and G. Schackert, Department of Neurosurgery, Heidelberg, FRG; M. Mühlbauer, Department of Neurosurgery, Vienna, Austria; R. W. Oberbauer and R. Pucher, Department of Neurosurgery, Graz, Austria; W. Peul and R. Braakman, Department of Neurosurgery, Rotterdam, The Netherlands; K. E. Richard, Department of Neurosurgery, Cologne, FRG; W. Serlo, Department of Paediatrics, Oulo, Finland; R. M. Villani, G. Tomei, and D. Spagnoli, Department of Neurosurgery, Milan, Italy
Rights and permissions
About this article
Cite this article
Oberbauer, R.W., Haase, J. & Pucher, R. Arachnoid cysts in children: a European co-operative study. Child's Nerv Syst 8, 281–286 (1992). https://doi.org/10.1007/BF00300797
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00300797