Neurocognitive profile in children with arachnoid cysts before and after surgical intervention

Treatment indications for arachnoid cysts are not clear. Some surgeons take improvement in neurocognitive function into account as a surgical indication for arachnoid cysts. However, only a few studies have evaluated the relationship between arachnoid cysts and neurocognitive function. Furthermore, studies that analyze neurocognitive function as an effect of arachnoid cyst surgery are even rarer. The purpose of this study was to analyze the neurocognitive function scores of children with arachnoid cysts before and after surgery and to examine whether surgical treatment led to improved neurocognitive function.

From June 2009 to August 2012, data for 24 children diagnosed with arachnoid cysts who underwent surgery at Seoul National University Children's Hospital were analyzed. Pre-operative and post-operative cyst volume was assessed and neurocognitive function was tested using the Korean version of the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Bender-Gestalt Test (BGT). Comparison of pre- and post-operative profiles by laterality of the arachnoid cyst was performed.

Patients had age-appropriate full-scale intelligent quotients (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) pre-operatively, which were maintained after surgery. Of the subtests, Block Design showed significant improvement post-operatively (p = 0.021). This means that visuo-spatial integration and mental construction abilities were improved after surgery. Patients with left or right arachnoid cysts did not show statistically significant changes in FSIQ, VIQ, or PIQ after surgery (110.21 versus 113.95, p = 0.307; 108.92 versus 111.54, p = 0.368; 107.88 versus 111.04, p = 0.152, respectively). Subanalysis showed that the pre- and post-operation VIQ mean scores of the patients with right arachnoid cysts were significantly higher (p < 0.054) than those of the patients with left arachnoid cysts, and there was no significant change after the surgery.

There was no significant association among cyst volume reduction, laterality, and clinical neurocognitive function improvement. The present findings indicate a limited role for surgical intervention in improving the intellectual abilities of children with arachnoid cysts.