title: Neurosurgical management of neurenteric cysts in children.
abstract: OBJECTIVE
  Neurenteric cysts (NCs) are endothelium-lined structures of presumed endodermal origin. There have been few pediatric series of intracranial NCs reported previously. The authors present their experience in the management of these lesions.
  
  
  METHODS
  A retrospective chart review of all cases of NCs identified between 1977 and 2007 was carried out. Demographics, details of clinical presentation, surgical therapy, and outcome data were extracted.
  
  
  RESULTS
  Eleven cases were identified, involving 6 girls and 5 boys. The patients' average age was 4.6 years (range 1 day-14 years). Limb weakness was the most common presenting symptom. The location of the cysts was cervical in 2 cases, cervicothoracic in 4 cases, and thoracic in 3 cases. One cyst was anterior to the pons with extension to the left cerebellopontine angle and 1 cyst was at the craniocervical junction. Five patients had an apparently complete initial excision, with 1 recurrence. Four patients were initially treated with incomplete excision and/or cyst drainage, usually into an Ommaya reservoir. A neonate with a large cervicothoracic cyst died of multiple congenital anomalies without any intervention. All other patients were alive at last follow-up. One patient with a radiologically identified presumed cyst, which remained stable, was simply followed up. Several patients required multiple procedures and 1 patient developed hydrocephalus after aseptic meningitis and was treated with CSF shunting.
  
  
  CONCLUSIONS
  Neurenteric cysts are rare in the pediatric population. Total resection, if possible, provides the best long-term outcome. Incomplete excision may lead to multiple procedures, including cyst drainage, but can lead to long-term stability.
authors: Division of Neurosurgery, The Hospital for Sick Children, The University of Toronto, Ontario, Canada. dr_nssa@hotmail.com
authors: Ibrahim H
authors: IH
authors: Al-Ahmed
authors: Mohamed
authors: M
authors: Boughamoura
authors: Peter
authors: P
authors: Dirks
authors: Abhaya V
authors: AV
authors: Kulkarni
authors: James T
authors: JT
authors: Rutka
authors: James M
authors: JM
authors: Drake
mesh_terms: D000293:Adolescent; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D005121:Extremities; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D018908:Muscle Weakness / Q000209:etiology*; D009436:Neural Tube Defects / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome