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Neurodevelopmental outcomes in children with large temporal arachnoid cysts
Mitchell Schertz1,2, Shlomi Constantini3,4, Rina Eshel3
11Child Development & Pediatric Neurology Service, Meuhedet-Northern Region, Haifa.
Insights
Children with large temporal arachnoid cysts (TACs) generally show similar neurodevelopmental outcomes to their siblings. However, a subset of these children face an elevated risk for poorer general functioning, underscoring the need for regular neurodevelopmental assessments.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Neurosurgery
Background:
- Management of large temporal arachnoid cysts (TACs) in children lacks consensus regarding neurodevelopmental outcomes.
- Limited data exists on the long-term neurodevelopmental impact of TACs.
Purpose of the Study:
- To investigate and assess the neurodevelopmental outcomes in children diagnosed with large temporal arachnoid cysts (TACs).
Main Methods:
- A cohort of 25 children with large TACs (Galassi types II and III) was evaluated.
- Neurodevelopmental function was assessed using ABAS, VBRS, and DCDQ, with quality of life measured by TOSQ.
- Sibling controls were used for comparison of neurodevelopmental assessments.
Main Results:
- Children with TACs demonstrated comparable performance to sibling controls on the ABAS, VBRS, and DCDQ.
- A trend indicated a higher incidence of poor outcomes (ABAS score < 80) in patients with TACs compared to controls (p=0.058).
- Surgically treated patients showed worse VBRS scores than non-surgically treated patients (p=0.020).
Conclusions:
- Children with large TACs exhibit similar neurodevelopmental function to their siblings.
- A subgroup of children with TACs is at increased risk for poor general functional outcomes.
- Routine neurodevelopmental assessment is crucial for managing children with TACs.
Abstract:
OBJECTIVE Management of children with large temporal arachnoid cysts (TACs) remains controversial, with limited data available on their neurodevelopmental outcome. The aim of this study was to examine neurodevelopmental outcomes in children with large TACs. METHODS In this medical center-based cohort study, 25 patients (19 males) who were diagnosed in childhood with large TACs (9 patients [36%] with a Galassi type II and 16 patients [64%] with a Galassi type III TAC) were examined. The mean ± SD age at assessment was 11.1 ± 5.6 years (range 2.7-22 years). Twelve patients (48%) had right-sided, 12 (48%) had left-sided, and 1 (4%) had bilateral cysts. Nine patients (36%) underwent surgery for the cyst. The siblings of 21 patients (84%) served as control participants. Neurodevelopmental function was assessed using the Adaptive Behavior Assessment System (ABAS), Vanderbilt Behavioral Rating Scale (VBRS), and Developmental Coordination Disorder Questionnaire (DCDQ), and quality of life was measured using the treatment-oriented screening questionnaire (TOSQ). The results of all instruments except for TOSQ were compared with those of the sibling control participants. RESULTS The mean ± SD ABAS score of the patients was 93.3 ± 20.09 compared with 98.3 ± 18.04 of the sibling control participants (p = 0.251). Regarding the incidence of poor outcome (ABAS score < 80), there was a trend for more patients with TAC to have poor outcome than the sibling controls (p = 0.058). Patients who underwent surgery scored significantly worse with regard to the VBRS total score compared with those who did not (p = 0.020), but not on ABAS, DCD, or TOSQ. The mean score of the cognitive and psychological items on TOSQ was lower than that for the physical items (p < 0.001). CONCLUSIONS Children with a large TAC performed similarly to their sibling control participants in neurodevelopmental function. However, a subgroup of those with cysts did have an increased risk for poor outcomes in general function. Neurodevelopmental assessment should be part of the management of all patients with TAC.
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