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Congenital arachnoid cyst of the lateral ventricles in children
J F Martínez-Lage1, M Poza, J Sola
1Regional Neurosurgical Service, University Hospital, Virgen de Arrixaca, Murcia, Spain.
Insights
Congenital arachnoid cysts in children can cause macrocephaly, developmental delays, and seizures. Surgical shunting effectively treats these intraventricular cysts.
Area of Science:
- Pediatric Neurosurgery
- Developmental Neuroscience
Background:
- Congenital arachnoid cysts are rare developmental abnormalities.
- Intraventricular arachnoid cysts can lead to significant neurological deficits in children.
Observation:
- Three pediatric cases of symptomatic congenital arachnoid cysts in the lateral ventricles are presented.
- Presenting symptoms included macrocephaly, delayed psychomotor development, and seizures.
- CT imaging revealed well-defined cystic lesions within the lateral ventricle atria.
Findings:
- Surgical intervention, including cysto-peritoneal shunts and ventriculo-cysto-peritoneal shunts, was performed.
- Ventriculoscopy facilitated cyst fenestration and precise shunt placement in one case.
- The proposed etiology involves the displacement of arachnoid cells during fetal development.
Implications:
- Early diagnosis and surgical management are crucial for improving neurological outcomes.
- Understanding the developmental origin may inform future prevention or treatment strategies.
- This case series highlights effective surgical approaches for intraventricular arachnoid cysts.
Abstract:
The authors report a series of three children with symptomatic congenital arachnoid cyst of the lateral ventricles. Presenting symptoms consisted of macrocephally, delay in psychomotor development, and seizures. CT findings were of a well-defined cystic lesion placed in the atrium of the lateral ventricle. One child was treated by direct cyst exposure and cysto-peritoneal shunt. The other two were treated with ventriculo-cysto-peritoneal shunts; in one of these, we used a ventriculoscope both for cyst fenestration and for accurate shunt placement. The origin of intraventricular arachnoid cysts seems to be secondary to the displacement of arachnoid cells by the vascular mesenchyma, through the choroid fissure, during the process of choroid plexus development.