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Child's Nervous System
Erschienen in: Child's Nervous System 5/2008

01.05.2008 | Controversy in Neurosurgery

Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management

verfasst von: Gianpiero Tamburrini, Mateus Del Fabbro, Concezio Di Rocco

Erschienen in: Child's Nervous System | Ausgabe 5/2008

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Abstract

Background

The management of Sylvian arachnoid cysts in children is still a matter of debate. Diagnosis is often incidental, and symptoms are frequently aspecific in symptomatic cases. Suggested diagnostic investigation results have been often unclear. Surgical treatment is also controversial, pure, and assisted endoscopic cyst marsupialization having entered in the traditional debate between craniotomic and shunting approach

Purpose

The objective of the present study was to survey if (and, eventually, which) agreement points do actually exist between internationally recognized pediatric neurosurgery centers in the management of children with a controversial type of Sylvian arachnoid cyst (Type II cyst).

Methods

Contributors were asked to answer to a six-separate-part multiple choice questionnaire related to the case of a 2.7-year-old boy with a Type II left Sylvian arachnoid cyst presented in different clinical situations. If surgery was indicated, it was asked which surgical procedure the authors would have suggested as first option.

Results and conclusions

The option of the mere clinical observation was chosen by the majority of surgeons in case of asymptomatic clinical discovery. On the other hand, a constantly high percentage of participants suggested direct surgical treatment based on clinical manifestations or as a preventive measure justified by the risk of spontaneous or traumatic intracranial bleeding. The only diagnostic investigation result which significantly influenced the surgical indication was a localizing electroencephalography, if the child presented with seizures. The result is that in most cases the surgical indication was based on aspecific clinical manifestations and laboratory data. Craniotomy and arachnoid cyst marsupialization represented the preferred surgical option (66.6%), 28.8% of the participants suggesting pure or assisted endoscopic cyst marsupialization as primary surgical procedure. Cyst shunting was suggested by only three centers.
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Metadaten
Titel
Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management
verfasst von
Gianpiero Tamburrini
Mateus Del Fabbro
Concezio Di Rocco
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 5/2008
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-008-0585-9

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