Frontal horn thin walled cysts in preterm neonates are benign

Area of Science:

• Neonatal Neurology
• Pediatric Radiology
• Neurodevelopmental Pediatrics

Background:

• Screening cranial ultrasounds identified isolated frontal horn cysts, differentiating them from periventricular leucomalacia cysts.
• These cysts are distinct lesions requiring further investigation into their clinical significance.

Purpose of the Study:

• To clarify the significance, incidence, characteristics, etiology, and long-term outcomes of isolated frontal horn cysts.
• To determine the prognostic implications of these specific neonatal brain cysts.

Main Methods:

• A retrospective observational study analyzed 2914 cranial ultrasounds from 1984-1994.
• Identified 21 neonates with frontal horn cysts; assessed sequential ultrasounds, maternal records, and neonatal events.
• Neurodevelopmental evaluations were obtained for survivors; postmortem studies examined cyst pathology.

Main Results:

• Fifteen neonates had isolated frontal horn cysts; 6 had additional abnormalities, including subependymal hemorrhage.
• Cysts displayed distinct morphology (elliptical, smooth, thin-walled, 3-20 mm) and location, enlarging then regressing by 2 months corrected age.
• 10 of 11 survivors with isolated cysts had normal neurodevelopmental outcomes; histological examination confirmed neuroblast and ependymal cell lining.

Conclusions:

• The incidence of frontal horn cysts was 0.7% in the scanned low birth weight population.
• These cysts appear in the first week of life, enlarge, and resolve spontaneously.
• Isolated frontal horn cysts have a benign prognosis with normal neurodevelopmental outcomes in survivors.