Presentation of intracranial arachnoid cysts in children: correlation between localization and clinical symptoms

The present study was performed in order to determine the most common neurological signs of arachnoid cysts (AC) in a pediatric population and to evaluate if there is a correlation between the localization of the cyst and the clinical characteristics.

Forty-five AC patients were studied, aged 2-17 years, who were consecutively referred to the Department of Developmental Neurology at the Medical University of Gdańsk between 1990-2001.

We found that AC has a strong predilection to the temporal regions and was associated with epilepsy in 31% of the cases. The patient's main complaint, however, was headache (in 69% of cases). In 6 cases AC required surgical treatment, because of intracranial hypertension. The AC concomitant with epilepsy had a significant predilection to the left temporal region (92% of cases).

The significance of this finding suggests the important role of the temporal lobe in the generation of epileptic activity; however, the association with the left cerebral hemisphere remains unclear. Although AC localized in the middle cerebral fossa are very often asymptomatic, in our opinion in many cases they may be the cause of, and have relationship with epilepsy and headaches in childhood and adolescence. For this reason MRI studies are necessary in any child with epilepsy and headaches of unclear etiology.