title: Surgery for intracranial arachnoid cysts in children-a prospective long-term study.
abstract: OBJECTIVE
  Intracranial arachnoid cysts are cystic malformations found in both adults and children. While many are asymptomatic, some cause symptoms and warrant surgical treatment. In this prospective population-based study, we aimed to study the short- and long-term outcome after surgical intervention in children with arachnoid cysts referred to our centre.
  
  
  METHODS
  Twenty-seven pediatric patients (13 f. 14 m, mean age 9.4 years) with de novo cysts were consecutively included during a 5-year period. The presenting symptoms were headache (n = 12), balance disturbance and dizziness (n = 6), seizures (n = 6), hydrocephalus (n = 5), and macrocephaly (n = 1). Twenty-two patients underwent surgical treatment with either microsurgical (n = 17) or endoscopic fenestration (n = 5) of the cyst wall. Cyst volume was measured with OsiriX® software pre- and postoperatively. Short-term and long-term follow-up of all patients was conducted 3 months and 8.6 years (7-10.5 years) postoperatively.
  
  
  RESULTS
  Three months after surgery, 59 % of the patients were improved regarding at least one major complaint, and average cyst volume was reduced to 33.3 ml (0-145 ml). At the long-term follow-up of 8.6 years, 77 % of the patients were improved regarding at least one symptom but subjective symptoms remained in 59 %. There was no permanent postoperative morbidity. We found no association between radiological reduction of cyst volume and clinical improvement.
  
  
  CONCLUSIONS
  Our findings support a restrictive attitude to surgery for intracranial arachnoid cysts, in the absence of objectively verified symptoms and signs or obstruction of CSF pathways.
authors.affiliation: Department of Neurosurgery, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden. katrin.rabiei_tabriz@vgregion.se.|Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. katrin.rabiei_tabriz@vgregion.se.
authors.forename: Katrin
authors.initials: K
authors.lastname: Rabiei
authors.affiliation: Department of Neurosurgery, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden.
authors.forename: Mats Johansson
authors.initials: MJ
authors.lastname: Högfeldt
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Roberto
authors.initials: R
authors.lastname: Doria-Medina
authors.affiliation: Department of Neurosurgery, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden.|Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Tisell
mesh_terms: D000293:Adolescent; D016080:Arachnoid Cysts / Q000150:complications / Q000601:surgery*; D002648:Child; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult
keywords: Arachnoid cysts; Cyst volume; Long-term outcome; Radiological versus clinical improvement