title: The treatment of large supratentorial arachnoid cysts in infants with cyst-peritoneal shunting and Hakim programmable valve.
abstract: OBJECTIVE
  This retrospective case series examines 7 infants with large supratentorial arachnoid cysts who underwent cyst-peritoneal shunting and insertion of a Hakim programmable valve. Comparing pre- and postoperative clinical data, neuroradiological and regional cerebral blood flow (rCBF) findings we evaluated the efficacy of the surgical procedure.
  
  
  METHODS
  Infants, ranging in age from 1 to 55 days (mean age 29.5 days), were assessed pre- and postoperatively by neurological examination, developmental profile and neuroimaging.
  
  
  RESULTS
  Post procedure, all patients showed a significant reduction in the cyst/brain ratio on neuroimaging (p<0.001), 6 had a normal developmental profile (p<0.001) and 5 cases showed a significant amelioration of clinical symptoms and neurological signs. Two patients underwent preoperative SPECT scans, which showed hypoperfusion in the area surrounding the cyst; this decreased rCBF also improved post shunting.
  
  
  CONCLUSIONS
  Large supratentorial arachnoid cysts in infants can be successfully treated with cyst-peritoneal shunting and insertion of a Hakim programmable valve. This is the first study specifically aimed at evaluating the long-term results of these conditions.
authors.affiliation: Neurosurgical Clinic A.O.U., University of Messina, Policlinico G. Martino, Via Consolare Valeria, 1, 98168 Messina, Italy. germano@unime.it
authors.forename: Antonino
authors.initials: A
authors.lastname: Germanò
authors.forename: Gerardo
authors.initials: G
authors.lastname: Caruso
authors.forename: Mariella
authors.initials: M
authors.lastname: Caffo
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.forename: Amedeo
authors.initials: A
authors.lastname: Calisto
authors.forename: Francesco
authors.initials: F
authors.lastname: Meli
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomasello
mesh_terms: D016080:Arachnoid Cysts / Q000473:pathology / Q000601:surgery*; D001927:Brain Diseases / Q000473:pathology / Q000601:surgery; D001931:Brain Mapping; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed