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Minerva Pediatrics 2021 Dec 03

DOI: 10.23736/S2724-5276.21.06583-6


lingua: Inglese

Surgical outcomes of congenital arachnoid cysts and their association with neurodevelopmental disorders

Joseph MEROLA 1 , Tiffany YE 1, Zoe JAMES 2, Milan MAKWANA 2, Jozsef LANG 2, Chirag PATEL 2, Paul LEACH 2

1 Cardiff University, Cardiff, UK; 2 University Hospital of Wales, Cardiff, UK


BACKGROUND: To evaluate the surgical outcomes of arachnoid cyst decompression in patients less than 16 years of age with an associated neurodevelopmental disorder (NDD).
METHODS: A retrospective analysis of surgically treated congenital arachnoid cyst within South Wales between 2010-2019. Surgical outcomes are measured according to clinical (COG; clinical outcome score) and radiological (NOG; neuroimaging outcome score) outcomes and the complication profiles are described. The association between arachnoid cysts and NDD both in South Wales and the literature review cohort is also discussed.
RESULTS: The prevalence of congenital arachnoid cysts in South Wales is 0.02% and their association with neurodevelopmental disorders among patients with a congenital arachnoid cyst is high (estimated prevalence 19%). 18 (51%) in total were surgically treated in our unit; 7 with an associated NDD. All surgical modalities showed improved clinical and radiological outcomes in those with an associated neurodevelopmental disorder. 4 (15%) patients who had endoscopic treatment, and 2 (7%) of those who underwent craniotomy had complications. No complications following cystoperitoneal shunt were seen. 4 (21%) surgically treated patients were ultimately shunted following initial treatment by endoscopy or craniotomy.
CONCLUSIONS: In a cohort of patients diagnosed with a congenital arachnoid cyst in association with a neurodevelopmental disorder, all surgical treatments show improved clinical and radiological outcomes. Cystoperitoneal shunting appears to have a favourable complication profile.

KEY WORDS: Intracranial arachnoid cyst; Neurodevelopmental disorder; Marsupialisation; Fenestration

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