Factors that Influence Subdural Hemorrhage Secondary to Intracranial Arachnoid Cysts in Children

Area of Science:

• Pediatric Neurosurgery
• Neuroradiology
• Medical Imaging

Background:

• Intracranial arachnoid cysts (IACs) are congenital malformations that can occasionally be associated with complications.
• Subdural haemorrhage (SDH) is a rare but serious complication of IACs in the pediatric population.
• Understanding the risk factors for SDH secondary to IACs is crucial for appropriate management and monitoring.

Purpose of the Study:

• To investigate the factors influencing the occurrence of subdural haemorrhage (SDH) secondary to intracranial arachnoid cysts (IACs) in children.
• To identify specific cyst characteristics and perinatal factors associated with SDH in pediatric patients with IACs.

Main Methods:

• Retrospective analysis of data from children with unruptured IACs and those with SDH secondary to IACs.
• Evaluation of nine factors: sex, age, birth type, symptoms, cyst side, location, image type (I, II, III), volume, and maximal diameter.
• Classification of IACs into types I, II, and III based on computed tomography (CT) imaging morphology.
• Logistic regression analysis with synthetic minority oversampling technique (SMOTE) to identify independent predictors.

Main Results:

• The study included 144 patients in the IAC group and 13 in the IAC-SDH group; 91.7% and 8.3% respectively.
• Univariate analysis revealed significant differences in age, birth type, symptoms, cyst location, volume, and maximal diameter between the groups (P < 0.05).
• Logistic regression identified Image Type III and caesarean delivery as independent factors influencing SDH secondary to IACs (AUC = 0.948).

Conclusions:

• Intracranial arachnoid cysts are more prevalent in boys.
• IACs can be categorized into three types based on CT imaging features.
• Image type III and caesarean delivery are significant independent predictors for the development of SDH secondary to IACs in children.