Pediatric interhemispheric arachnoid cyst: An institutional experience.

Area of Science:

• Pediatric Neurosurgery
• Congenital Neurological Disorders
• Cystic Lesions of the Brain

Background:

• Interhemispheric arachnoid cysts (IHACs) are rare congenital brain malformations, representing less than 5% of all arachnoid cysts.
• Optimal surgical management for symptomatic IHACs remains debated due to a lack of established guidelines.

Purpose of the Study:

• To evaluate the safety and efficacy of surgical interventions for pediatric interhemispheric arachnoid cysts.
• To compare outcomes of endoscopic cyst fenestration versus cystoperitoneal shunt surgery in IHAC management.

Main Methods:

• Retrospective analysis of six pediatric patients with IHACs treated between 2012 and 2015.
• Surgical procedures included endoscopic cystoventriculostomy, cystocisternostomy, and cystoperitoneal shunt (three patients each).
• All patients were male, with a median age of 13 months at presentation.

Main Results:

• Common presentations included macrocrania, seizures, infantile spasms, and developmental delay.
• Mean follow-up duration was 24.16 months (range: 3-36 months).
• All patients showed cyst size reduction and head size stabilization, with no need for reoperation.

Conclusions:

• Endoscopic cyst fenestration and shunt surgery are both safe and effective treatment options for pediatric IHACs.
• These surgical strategies lead to favorable outcomes, including cyst reduction and clinical stabilization.