J Neurol Surg A Cent Eur Neurosurg 2020; 81(04): 362-367
DOI: 10.1055/s-0039-1698385
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Cognitive Impairment in Children with Arachnoid Cyst of Sylvian Fissure: Does it Justify the Neurosurgical Treatment?

Karolina Kwiatkowska
1   Clinic of Children's Neurosurgery, Jagiellonian University School of Medicine, Kraków, Poland
,
Magdalena Dębicka
1   Clinic of Children's Neurosurgery, Jagiellonian University School of Medicine, Kraków, Poland
,
Agnieszka Maryniak
2   Faculty of Psychology, University of Warsaw, Warszawa, Poland
,
Stanisław Kwiatkowski
1   Clinic of Children's Neurosurgery, Jagiellonian University School of Medicine, Kraków, Poland
› Author Affiliations
Further Information

Publication History

17 January 2019

06 February 2019

Publication Date:
15 April 2020 (online)

Abstract

This report discusses the relationship between arachnoid cysts (ACs) and cognitive deficits, and we ask if cognitive impairments could justify neurosurgical treatment. In clinical practice, only AC patients with symptoms of intracranial hypertension or focal neurological deficits are referred to surgery. Occasionally, one might assume that nonspecific problems such as impairment of learning, speech, or cognitive functions are caused by an AC and can be improved by surgery. We describe three patients, in which surgery was indicated on the basis of clinical symptoms such as headaches and the size of the cysts. A neuropsychological examination before AC surgery revealed reduced cognitive potential, and the same examination repeated after surgery showed improvement. We have not found any other reason for this change, except for the decompression of the AC.

 
  • References

  • 1 Adeeb N, Deep A, Griessenauer CJ. , et al. The intracranial arachnoid mater : a comprehensive review of its history, anatomy, imaging, and pathology. Childs Nerv Syst 2013; 29 (01) 17-33
  • 2 Auer LM, Gallhofer B, Ladurner G, Sager WD, Heppner F, Lechner H. Diagnosis and treatment of middle fossa arachnoid cysts and subdural hematomas. J Neurosurg 1981; 54 (03) 366-369
  • 3 Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 2010; 5 (06) 578-585
  • 4 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 (05) 363-369
  • 5 Gosalakkal JA. Intracranial arachnoid cysts in children: a review of pathogenesis, clinical features, and management. Pediatr Neurol 2002; 26 (02) 93-98
  • 6 Oberbauer RW, Haase J, Pucher R. Arachnoid cysts in children: a European co-operative study. Childs Nerv Syst 1992; 8 (05) 281-286
  • 7 Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus 2007; 22 (02) E7
  • 8 Ali M, Bennardo M, Almenawer SA. , et al. Exploring predictors of surgery and comparing operative treatment approaches for pediatric intracranial arachnoid cysts: a case series of 83 patients. J Neurosurg Pediatr 2015; 16 (03) 275-282
  • 9 Cincu R, Agrawal A, Eiras J. Intracranial arachnoid cysts: current concepts and treatment alternatives. Clin Neurol Neurosurg 2007; 109 (10) 837-843
  • 10 Harsh IV GR, Edwards MS, Wilson CB. Intracranial arachnoid cysts in children. J Neurosurg 1986; 64 (06) 835-842
  • 11 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 (05) 934-939
  • 12 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 Neurol Neurosurg Psychiatry 1994; 57 (03) 296-300
  • 13 Rabiei K, Jaraj D, Marlow T, Jensen C, Skoog I, Wikkelsø C. Prevalence and symptoms of intracranial arachnoid cysts: a population-based study. J Neurol 2016; 263 (04) 689-694
  • 14 Sgouros S, Chapman S. Congenital middle fossa arachnoid cysts may cause global brain ischaemia: a study with 99Tc-hexamethylpropyleneamineoxime single photon emission computerised tomography scans. Pediatr Neurosurg 2001; 35 (04) 188-194
  • 15 Shim KW, Lee YH, Park EK, Park YS, Choi JU, Kim DS. Treatment option for arachnoid cysts. Childs Nerv Syst 2009; 25 (11) 1459-1466
  • 16 Zaatreh MM, Bates ER, Hooper SR. , et al. Morphometric and neuropsychologic studies in children with arachnoid cysts. Pediatr Neurol 2002; 26 (02) 134-138
  • 17 Kwiatkowska K, Hałabuda A, Rybus J, Kwiatkowski S. Cognitive disorders in a patient with an arachnoid cyst of the sylvian fissure and improvement after surgical treatment: case description. Appl Neuropsychol Child 2017; 7: 1-5
  • 18 Rabiei K, Hellström P, Högfeldt-Johansson M, Tisell M. Does subjective improvement in adults with intracranial arachnoid cysts justify surgical treatment?. J Neurosurg 2018; 128 (01) 250-257
  • 19 Schertz M, Constantini S, Eshel R, Sela AH, Roth J, Fattal-Valevski A. Neurodevelopmental outcomes in children with large temporal arachnoid cysts. J Neurosurg Pediatr 2018; 21 (06) 578-586
  • 20 Wester K. Intracranial arachnoid cysts—do they impair mental functions?. J Neurol 2008; 255 (08) 1113-1120
  • 21 Wester K, Hugdahl K. Verbal laterality and handedness in patients with intracranial arachnoid cysts. J Neurol 2003; 250 (01) 36-41
  • 22 Winczewska-Wiktor A, Steinborn B, Młodzikowska-Albrecht J, Paprzycki W, Zakrzewska M. The analysis of clinical symptoms of patients in developmental age with intracranial cysts. Child Neurol 2006; 29: 35-44
  • 23 Bechter K, Wittek R, Seitz K, Antoniadis G. Personality disorders improved after arachnoid cyst neurosurgery, then rediagnosed as ‘minor’ organic personality disorders. Psychiatry Res 2010; 184 (03) 196-200
  • 24 Kuhnley EJ, White DH, Granoff AL. Psychiatric presentation of an arachnoid cyst. J Clin Psychiatry 1981; 42 (04) 167-168
  • 25 Vakis AF, Koutentakis DI, Karabetsos DA, Kalostos GN. Psychosis-like syndrome associated with intermittent intracranial hypertension caused by a large arachnoid cyst of the left temporal lobe. Br J Neurosurg 2006; 20 (03) 156-159
  • 26 Millichap JG. Temporal lobe arachnoid cyst-attention deficit disorder syndrome: role of the electroencephalogram in diagnosis. Neurology 1997; 48 (05) 1435-1439
  • 27 Cuny ML, Pallone M, Piana H. , et al. Neuropsychological improvement after posterior fossa arachnoid cyst drainage. Childs Nerv Syst 2017; 33 (01) 135-141
  • 28 Di Rocco C. Sylvian fissure arachnoid cysts: we do operate on them but should it be done?. Childs Nerv Syst 2010; 26 (02) 173-175
  • 29 B Gjerde P, Schmid M, Hammar A, Wester K. Intracranial arachnoid cysts: impairment of higher cognitive functions and postoperative improvement. J Neurodev Disord 2013; 5 (01) 21
  • 30 Helland CA, Wester K. Intracystic pressure in patients with temporal arachnoid cysts: a prospective study of preoperative complaints and postoperative outcome. J Neurol Neurosurg Psychiatry 2007; 78 (06) 620-623
  • 31 Mørkve SH, Helland CA, Amus J, Lund-Johansen M, Wester KG. Surgical decompression of arachnoid cysts leads to improved quality of life: a prospective study. Neurosurgery 2016; 78 (05) 613-625
  • 32 Raeder MB, Helland CA, Hugdahl K, Wester K. Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology 2005; 64 (01) 160-162
  • 33 Wester K, Hugdahl K. Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry 1995; 59 (03) 293-298
  • 34 Hałabuda A, Franczak-Young A, Klasa Ł, Wyrobek Ł, Kawecki Z, Kwiatkowski S. Arachnoid cysts of sylvian fissure in pediatric population—difficulties in qualification for surgical treatment. Medicina Internacia Revuo 2016; 27 (106) 11-19
  • 35 Helland CA, Wester K. A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults. J Neurol Neurosurg Psychiatry 2007; 78 (10) 1129-1135
  • 36 Tamburrini G, Dal Fabbro M, Di Rocco C. Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst 2008; 24 (05) 593-604