Abstract
Various types of neuroimaging investigations were performed in 26 patients with posterior fossa cysts. The results were retrospectively analyzed to facilitate differential diagnosis and clarify indications for surgery. Four major findings were obtained in this study. First, posterior fossa intra-arachnoid cysts were encountered more frequently than expected and were found to be surgically treatable. Second, although IV ventricular cysts were categorized as Dandy-Walker malformation, Dandy-Walker variant, and persistent Blake's pouch in this study, the distinctions of neuroimaging findings between these three types are uncertain. Third, the diagnostic criteria for mega cisterna magna were established, and it was found be be a surgically untreatable condition. Finally, in cases with the following neuroimaging findings, surgery appears to be indicated: (1) occipital bossing or petrosal scalloping with distortion or obliteration of cerebrospinal fluid (CSF) cisterns of the posterior fossa; (2) compression and deformity of the brain surrounding the cyst; (3) radioisotope and/or computed tomography cisternographic findings suggestive of disturbance of intracystic CSF circulation; (4) a non-communicating cyst.
Similar content being viewed by others
References
Adam R, Greenberg JO (1978) The mega cisterna magna. J Neurosurg 48:190–192
Alvord EC Jr, Marcuse PM (1962) Intracranial cerebellar meningoencephalocele (posterior fossa cyst) causing hydrocephalus by compression at the incisura tentorii. J Neuropathol Exp Neurol 21:50–69
Barkvovich AJ, Kjos BO, Norman D, Edwards MS (1989) Revised classification of posterior fossa cyst and cystlike malformations based on the results of multiplanar MR imaging. AJNR 10:977–988
Di Rocco C, Caldarelli M, Trapani G di (1981) Infratentorial arachnoid cysts in children. Child's Brain 8:119–133
Galassi E, Piazza G, Gaist G, Frank F (1980) Arachnoid cysts of the middle cranial fossa. A clinical and radiological study of 25 cases treated surgically. Surg Neurol 14:211–219
Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G (1985) Infratentorial arachnoid cyst. J Neurosurg 63:210–217
Handa J, Nakano Y, Aii H (1977) CT cisternography with intracranial arachnoid cysts. Surg Neurol 8:451–454
Hanigan WC, Wright R, Wright S (1985/86) Magnetic resonance imaging of the Dandy-Walker malformation. Pediatr Neurosci 12:151–156
Harwood-Nash DC, Fitz CR (1976) Neuroradiology in infants and children. Mosby, St Louis, Mo
Ho KL, Chason JL (1987) A glioependymal cyst of the cerebellopontine angle. Acta Neuropathol (Berlin) 74:382–388
Kendall BE, Kingsley D (1978) The value of computerized axial tomography (CAT) in cranio-cerebral malformation. Br J Radiol 51:171–190
Little JR, Gomez MR, MacCarty CS (1973) Infratentorial arachnoid cysts. J Neurosurg 39:380–386
Naidich TP, McLone DG, Radkowski MA (1985/86) Intracranial arachnoid cysts. Pediatr Neurosci 12:112–122
Poe LB, Coleman LL, Mahmud F (1989) Congenital central nervous system anomalies. Radiographics 9:801–826
Raimondi AJ, Sato K, Shimoji T (1984) The Dandy-Walker syndrome. Karger, Basel, pp 1–75
Raybaud C (1982) Cystic malformation of the posterior fossa. Abnormalities associated with the development of the roof of the fourth ventricle and adjacent meningeal structures. J Neuroradiol 9:103–133
Reider-Groswasser I, Catz A, Harel S (1987) Posterior fossa lesions in childhood and infancy. Child's Nerv Syst 3:213–218
Rengachary SS, Watanabe I (1981) Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol 40:61–83
Rock JP, Zimmerman R, Bell WO, Fraser RAR (1986) Arachnoid cysts of the posterior fossa. Neurosurgery 18:176–179
Sato K, Shimoji T, Yaguchi K, Sumie H, Kuru Y, Ishii S (1983) Middle fossa arachnoid cyst: clinical, neuroradiological, and surgical features. Child's Brain 10:301–316
Shaw CM, Alvord EC Jr (1977) Congenital arachnoid cysts and their differential dignosis. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 31. North-Holland, Amsterdam
Starkman SP, Brown TC, Linell EA (1958) Cerebral arachnoid cysts. J Neuropathol Exp Neurol 17:484–500
Veyrac C, Couture C, Baud C (1986) Posterior fossa cystic malformation: ultrasonic approach. Ann Radiol 29:353–362
Wolpert SM, Scott RM (1981) The value of metrizamide CT cisternography in the management of cerebral arachnoid cysts. AJNR 2:29–35
Wolpert SM, Scott RM, Runge VM, Kwan ESK (1987) Difficulties in diagnosing congenital posterior fossa fluid collections after shunting procedures. AJNR 8:653–656
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Arai, H., Sato, K. Posterior fossa cysts: clinical, neuroradiological and surgical features. Child's Nerv Syst 7, 156–164 (1991). https://doi.org/10.1007/BF00776713
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00776713