title: [Diagnosis, evolution and prognosis of prenatally diagnosed suprasellar cysts].
abstract: Suprasellar arachnoid cysts (SAC) in children are considered rare, but the incidence is increasing due to the improvement of prenatal diagnosis. We present 15 cases of SAC diagnosed during the antenatal period between 2005 and 2015. The records were reviewed retrospectively by specifying the radiological characteristics, treatment modalities, outcomes, and long-term monitoring. Mean follow-up was 71 months. The forms (SAC-1) accounted for 2 cases (13%) with hydrocephalus. We observed 8 (53%) lower forms (SAC-2) with interpeduncular cistern expansion without hydrocephalus. The 5 (33.5%) remaining patients showed asymmetrical forms (SAC-3). Six patients (40%) were treated by ventriculo-cysto-cisternostomy, 1 by fetoscopy, 1 (6.5%) by ventriculo-peritoneal shunt, 2 (13.5%) by pterional craniotomy, and 6 (40%) were simply followed. The surgical outcomes were initially favorable in 9 cases (100%), 1 patient (13%) had to be re-treated later. Non-operated patients were all type 2 and showed no radiological changes. In the long-term, 1 patient (6.5%) had endocrine disruption, 1 had delayed development, 2 (13.5%) had minor neuropsychological impairments, and 1 had epilepsy. Combined monitoring with prenatal MRI and ultrasound can be used to distinguish three subtypes of SAC. SAC-1 and SAC-3 have an excellent prognosis after treatment in the perinatal period. SAC-2 can benefit from simple monitoring and remain asymptomatic in their majority. This classification allows a better prognosis estimation and better treatment decision.
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France. Electronic address: federico.dirocco@nck.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Di Rocco
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: A
authors.initials: A
authors.lastname: André
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: T
authors.initials: T
authors.lastname: Roujeau
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: L
authors.initials: L
authors.lastname: Selek
authors.affiliation: Service de gynécologie-obstétrique, hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
authors.affiliation: Service de radiologie pédiatrique, hôpital Armand-Trousseau, AP-HP, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Garel
authors.affiliation: Service de neurochirurgie pédiatrique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: M
authors.initials: M
authors.lastname: Zérah
mesh_terms: D000293:Adolescent; D016080:Arachnoid Cysts / Q000601:surgery*; D020863:Central Nervous System Cysts / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019150:Neuroaxonal Dystrophies; D010022:Osteopetrosis; D011247:Pregnancy; D011379:Prognosis; D017287:Ventriculoperitoneal Shunt / Q000379:methods
keywords: Development; Diagnostic prénatal; Développement; Endoscopie; Endoscopy; Hydrocephalus; Hydrocéphalie; IRM; Intracranial cyst; Kystes intracrâniens; Liliequist membrane; MRI; Macrocrania; Macrocrânie; Membrane de Liliequist; Prenatal diagnosis; Ultrasound; Échographie