Location, sidedness, and sex distribution of incidental intracranial arachnoid cysts in childhood: An MRI study
Abstract
Objective: The objective of
this study was to evaluate retrospectively the MRI features of incidental
intracranial arachnoid cysts with regard to their distribution of cyst
location, sidedness, Galassi type, and gender in children during the workup for
headache and seizures.
Method: MRI scans of the
head performed from May 2005 to May 2015 were reviewed retrospectively to
analyze arachnoid cysts detected incidentally in children.
Results: The mean ages of boys (n=63) and girls
(36) were 8.4±5.0 (2 months to 18 years) and 8.9±4.0 (6 months to 14 years),
respectively. Although the number of boys with left, right or midline sidedness
was higher compared to girls, these differences were not reached statistical
significance (p>0.5). For both boys and girls, arachnoid cysts were located
in middle cranial fossa, frontal convexity, and posterior fossa significantly
more commonly than other locations. Overall, for all locations, the number of
boys was greater compared to girls. Although the number of boys with Galassi
types I, II, and III was greater compared to girls, these differences did not
reach statistical significance.
Conclusions: In carefully selected patients, MRI
provides information about presence and nature of arachnoid cysts that are
otherwise impossible to detect clinically. Intracranial arachnoid cysts are one
of the important incidental findings detected during the MRI of head. In an MRI
report, the size, location, and other important features of arachnoid cysts
need to be described in detail for the long-term follow-up and management of
these benign lesions that are most commonly asymptomatic but may present with
severe symptoms in some cases.
References
- 1. Chen CP. Prenatal diagnosis of arachnoid cysts. Taiwan J Obstet Gynecol. 2007; 46(3):187-98.
- 2. Patel TR, Bannister CM, Thorne J. A study of prenatal ultrasound and postnatal magnetic imaging in the diagnosis of central nervous system abnormalities. Eur J Pediatr Surg. 2003; 13 Suppl 1:S18-22.
- 3. Pascual-Castroviejo I, Roche MC, Martínez Bermejo A, Arcas J, GarcíaBlázquez M. Primary intracranial arachnoidal cysts. A study of 67 childhood cases. Childs Nerv Syst. 1991;7(5):257-63.
- 4. Khan AN. Arachnoid Cyst Imaging. Available at: www.medscape.com. Accessed on: October 2013.
- 5. Catala M, Poirier J. [Arachnoid cysts: histologic, embryologic and physiopathologic review]. Rev Neurol (Paris). 1998; 154(6-7):489-501.
- 6. Zada G, Krieger MD, McNatt SA, Bowen I, McComb JG. Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age. Neurosurg Focus. 2007;22(2):E1.
- 7. Lee JY, Kim JW, Phi JH, Kim SK, Cho BK, Wang KC. Enlarging arachnoid cyst: a false alarm for infants. Childs Nerv Syst. 2012; 28(8):1203-11
- 8. Murthy JM. Intracranial arachnoid cysts: Epileptic seizures. Neurol India. 2013; 61(4):343-4.
- 9. De Volder AG, Michel C, Thauvoy C, Willems G, Ferrière G. Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J NeurolNeurosurg Psychiatry. 1994; 57(3):296-300.
- 10. Colameco S, DiTomasso RA. Arachnoid cyst associated with psychological disturbance. J Med Soc N J. 1982; 79(3):209-10.
- 11. Lang W, Lang M, Kornhuber A, Gallwitz A, Kriebel J. Neuropsychological and neuroendocrinological disturbances associated with extracerebral cysts of the anterior and middle cranial fossa. Eur Arch Psychiatry Neurol Sci. 1985; 235(1):38-41.
- 12. Albuquerque FC, Giannotta SL. Arachnoid cyst rupture producing subdural hygroma and intracranial hypertension: case reports. Neurosurgery. 1997; 41(4):951-5; discussion 955-6.
- 13. Thinakara-Rajan T, Janjua A, Srinivasan V. Posterior fossa arachnoid cyst presenting with isolated sensorineural hearing loss. J Laryngol Otol. 2006; 120(11):979-82.
- 14. Raeder MB, Helland CA, Hugdahl K, Wester K. Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology. 2005; 64(1):160-2.
- 15. Wester K, Hugdahl K. Verbal laterality and handedness in patients with intracranial arachnoid cysts. J Neurol. 2003; 250(1):36-41.
- 16. Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-HUNT-Youth), a large population-based epidemiological study. Cephalalgia. 2004; 24(5):373-9.
- 17. Martens D, Oster I, Gottschlling S, Papanagiotou P, Ziegler K, Eymann R, Ong MF, Gortner L, Meyer S. Cerebral MRI and EEG studies in the initial management of pediatric headaches. Swiss Med Wkly. 2012; 142:w13625.
- 18. Abu-Arafeh I, Macleod S. Serious neurological disorders in children with chronic headache. Arch Dis Child. 2005; 90(9):937-40.
- 19. Alexiou GA, Argyropoulou MI. Neuroimaging in childhood headache: a systematic review. PediatrRadiol. 2013; 43(7):777-84.
- 20. Wester K. Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery. 1999; 45(4):775-9.
- 21. Ozge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl C. Overview of diagnosis and management of paediatric headache. Part I: diagnosis. J Headache Pain. 2011; 12(1):13-23.
- 22. Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007; 22(2):E7.
- 23. Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, Frank G. CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol. 1982; 17(5):363-9.
- 24. Yildiz H, Erdogan C, Yalcin R, Yazici Z, Hakyemez B, Parlak M, Tuncel E. Evaluation of communication between intracranial arachnoid cysts and cisterns with phase-contrast cine MR imaging. AJNR Am J Neuroradiol. 2005; 26(1):145-51.
- 25. Koc G, Altay C, Bozkurt T, Varer M, Oyar O. Multiple intracranial arachnoid cysts. JBR-BTR. 2012; 95(5):339.
- 26. Gelabert-González M. [Intracranial arachnoid cysts]. Rev Neurol. 2004; 39(12):1161-6.
- 27. Helland CA, Wester K. A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults. J NeurolNeurosurg Psychiatry. 2007; 78(10):1129-35.
- 28. Helland CA, Lund-Johansen M, Wester K. Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. J Neurosurg. 2010; 113(5):934-9.
- 29. Geschwind N, Galaburda AM. Cerebral lateralization. Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch Neurol. 1985; 42(5):428-59.
- 30. Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J. Arachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg. 1984; 60(4):803-13.
- 31. Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. J NeuropatholExp Neurol. 1981; 40(1):61-83.
- 32. Erdincler P, Kaynar MY, Bozkus H, Ciplak N. Posterior fossa arachnoid cysts. Br J Neurosurg. 1999 ;13(1):10-7.
- 33. Marin-Sanabria EA, Yamamoto H, Nagashima T, Kohmura E. Evaluation of the management of arachnoid cyst of the posterior fossa in pediatric population: experience over 27 years. Childs Nerv Syst. 2007; 23(5):535-42.
- 34. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, Park YS, Lee SW. Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Childs Nerv Syst. 2000; 16(2):111-6.
- 35. Fewel ME, Levy ML, McComb JG. Surgical treatment of 95 children with 102 intracranial arachnoid cysts. PediatrNeurosurg. 1996; 25(4):165-73.
- 36. Lee EJ, Ra YS. Clinical and neuroimaging outcomes of surgically treated intracranial cysts in 110 children. J Korean Neurosurg Soc. 2012; 52(4):325-33.
- 37. Ozek MM, Urgun K. Neuroendoscopic management of suprasellar arachnoid cysts. World Neurosurg. 2013; 79(2 Suppl): S19.e13-8.
Çocukluk çağındaki rastlantısal intrakranyal araknoid kistlerin lokalizasyonu, yönü ve cinsiyet dağılımı: Bir MRG çalışması
Abstract
Amaç: Bu çalışmanın amacı, rastlantısal
intrakranyal araknoid kistlerin manyetik rezonans görüntüleme (MRG)
özelliklerini, baş ağrısı ve nöbetler için yapılan çalışmalarda çocuklarda kist
yeri, yönü, Galassi tipi ve cinsiyet dağılımı açısından retrospektif olarak
değerlendirmektir.
Yöntem: Mayıs 2005 ile Mayıs 2015 arasında
yapılan kranyal MRG taramaları, çocuklarda tesadüfen tespit edilen araknoid
kistler açısından geriye dönük olarak incelendi.
Bulgular: Erkeklerin (n = 63) ve kızların (36) yaş
ortalaması 8.4 ± 5.0 (2 ay-18 yaş) ve 8.9 ± 4.0 (6 ay- 14 yıl) arasında
değişmektedir. Erkeklerin say7ısı, kızlara göre sağ, sol veya orta hat
yanılgısına göre daha yüksek olmasına rağmen istatistiksel olarak anlamlı
değildi (p> 0.5). Hem erkek hem de kızlar için, orta kranyal fossa, frontal
konveksite ve posterior fossa diğer yerlerden anlamlı olarak daha yüksekti.
Genel olarak, tüm bölgeler için, erkeklerin sayısı kızlara göre daha fazla idi.
Galassi tip I, II ve III'e göre erkek çocuk sayısı kızlara göre daha yüksek
olmasına rağmen, bu farklılıklara istatistiksel olarak anlamlı bir fark
bulunamamıştır.
Sonuç: Dikkat çekici olarak seçilen hastalarda
MRG, araknoid kistlerin varlığı ve doğası hakkında bilgi verir, aksi takdirde
klinik olarak tespit edilemez. İntrakranyal araknoid kist, MRG sırasında
saptanan önemli tesadüfî bulgulardan biridir. MRG raporunda, araknoid kistlerin
büyüklüğü, yeri ve diğer önemli özellikleri, en yaygın olarak asemptomatik
olan, ancak bazı durumlarda şiddetli semptomlarla ortaya çıkan benign
lezyonların uzun vadeli takip ve yönetimi için detaylı olarak tanımlanmalıdır.
References
- 1. Chen CP. Prenatal diagnosis of arachnoid cysts. Taiwan J Obstet Gynecol. 2007; 46(3):187-98.
- 2. Patel TR, Bannister CM, Thorne J. A study of prenatal ultrasound and postnatal magnetic imaging in the diagnosis of central nervous system abnormalities. Eur J Pediatr Surg. 2003; 13 Suppl 1:S18-22.
- 3. Pascual-Castroviejo I, Roche MC, Martínez Bermejo A, Arcas J, GarcíaBlázquez M. Primary intracranial arachnoidal cysts. A study of 67 childhood cases. Childs Nerv Syst. 1991;7(5):257-63.
- 4. Khan AN. Arachnoid Cyst Imaging. Available at: www.medscape.com. Accessed on: October 2013.
- 5. Catala M, Poirier J. [Arachnoid cysts: histologic, embryologic and physiopathologic review]. Rev Neurol (Paris). 1998; 154(6-7):489-501.
- 6. Zada G, Krieger MD, McNatt SA, Bowen I, McComb JG. Pathogenesis and treatment of intracranial arachnoid cysts in pediatric patients younger than 2 years of age. Neurosurg Focus. 2007;22(2):E1.
- 7. Lee JY, Kim JW, Phi JH, Kim SK, Cho BK, Wang KC. Enlarging arachnoid cyst: a false alarm for infants. Childs Nerv Syst. 2012; 28(8):1203-11
- 8. Murthy JM. Intracranial arachnoid cysts: Epileptic seizures. Neurol India. 2013; 61(4):343-4.
- 9. De Volder AG, Michel C, Thauvoy C, Willems G, Ferrière G. Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J NeurolNeurosurg Psychiatry. 1994; 57(3):296-300.
- 10. Colameco S, DiTomasso RA. Arachnoid cyst associated with psychological disturbance. J Med Soc N J. 1982; 79(3):209-10.
- 11. Lang W, Lang M, Kornhuber A, Gallwitz A, Kriebel J. Neuropsychological and neuroendocrinological disturbances associated with extracerebral cysts of the anterior and middle cranial fossa. Eur Arch Psychiatry Neurol Sci. 1985; 235(1):38-41.
- 12. Albuquerque FC, Giannotta SL. Arachnoid cyst rupture producing subdural hygroma and intracranial hypertension: case reports. Neurosurgery. 1997; 41(4):951-5; discussion 955-6.
- 13. Thinakara-Rajan T, Janjua A, Srinivasan V. Posterior fossa arachnoid cyst presenting with isolated sensorineural hearing loss. J Laryngol Otol. 2006; 120(11):979-82.
- 14. Raeder MB, Helland CA, Hugdahl K, Wester K. Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology. 2005; 64(1):160-2.
- 15. Wester K, Hugdahl K. Verbal laterality and handedness in patients with intracranial arachnoid cysts. J Neurol. 2003; 250(1):36-41.
- 16. Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-HUNT-Youth), a large population-based epidemiological study. Cephalalgia. 2004; 24(5):373-9.
- 17. Martens D, Oster I, Gottschlling S, Papanagiotou P, Ziegler K, Eymann R, Ong MF, Gortner L, Meyer S. Cerebral MRI and EEG studies in the initial management of pediatric headaches. Swiss Med Wkly. 2012; 142:w13625.
- 18. Abu-Arafeh I, Macleod S. Serious neurological disorders in children with chronic headache. Arch Dis Child. 2005; 90(9):937-40.
- 19. Alexiou GA, Argyropoulou MI. Neuroimaging in childhood headache: a systematic review. PediatrRadiol. 2013; 43(7):777-84.
- 20. Wester K. Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery. 1999; 45(4):775-9.
- 21. Ozge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl C. Overview of diagnosis and management of paediatric headache. Part I: diagnosis. J Headache Pain. 2011; 12(1):13-23.
- 22. Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007; 22(2):E7.
- 23. Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, Frank G. CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol. 1982; 17(5):363-9.
- 24. Yildiz H, Erdogan C, Yalcin R, Yazici Z, Hakyemez B, Parlak M, Tuncel E. Evaluation of communication between intracranial arachnoid cysts and cisterns with phase-contrast cine MR imaging. AJNR Am J Neuroradiol. 2005; 26(1):145-51.
- 25. Koc G, Altay C, Bozkurt T, Varer M, Oyar O. Multiple intracranial arachnoid cysts. JBR-BTR. 2012; 95(5):339.
- 26. Gelabert-González M. [Intracranial arachnoid cysts]. Rev Neurol. 2004; 39(12):1161-6.
- 27. Helland CA, Wester K. A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults. J NeurolNeurosurg Psychiatry. 2007; 78(10):1129-35.
- 28. Helland CA, Lund-Johansen M, Wester K. Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. J Neurosurg. 2010; 113(5):934-9.
- 29. Geschwind N, Galaburda AM. Cerebral lateralization. Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch Neurol. 1985; 42(5):428-59.
- 30. Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J. Arachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg. 1984; 60(4):803-13.
- 31. Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. J NeuropatholExp Neurol. 1981; 40(1):61-83.
- 32. Erdincler P, Kaynar MY, Bozkus H, Ciplak N. Posterior fossa arachnoid cysts. Br J Neurosurg. 1999 ;13(1):10-7.
- 33. Marin-Sanabria EA, Yamamoto H, Nagashima T, Kohmura E. Evaluation of the management of arachnoid cyst of the posterior fossa in pediatric population: experience over 27 years. Childs Nerv Syst. 2007; 23(5):535-42.
- 34. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, Park YS, Lee SW. Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Childs Nerv Syst. 2000; 16(2):111-6.
- 35. Fewel ME, Levy ML, McComb JG. Surgical treatment of 95 children with 102 intracranial arachnoid cysts. PediatrNeurosurg. 1996; 25(4):165-73.
- 36. Lee EJ, Ra YS. Clinical and neuroimaging outcomes of surgically treated intracranial cysts in 110 children. J Korean Neurosurg Soc. 2012; 52(4):325-33.
- 37. Ozek MM, Urgun K. Neuroendoscopic management of suprasellar arachnoid cysts. World Neurosurg. 2013; 79(2 Suppl): S19.e13-8.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | March 20, 2018 |
| Acceptance Date | December 29, 2017 |
| Published in Issue | Year 2018Volume: 40 Issue: 1 |