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Massive intracranial arachnoid cyst in a developmentally normal infant: case report and literature review
T B Mason1, C A Chiriboga, N A Feldstein
1Department of Neurology, Harlem Hospital Center, New York, USA.
Insights
A rare, massive intracranial arachnoid cyst caused macrocephaly in an infant. Surgical intervention with a cystoperitoneal shunt successfully reduced cyst size and improved brain tissue reexpansion, offering a low-risk, high-success treatment option.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Neurosurgery
Background:
- Intracranial arachnoid cysts are congenital malformations typically presenting without symptoms.
- Massive basal arachnoid cysts are exceptionally rare and can cause significant neurological complications due to mass effect.
Observation:
- A 6-month-old male infant presented with macrocephaly but maintained normal neurological development.
- Imaging revealed an unusually large basal arachnoid cyst occupying a substantial portion of the cranial cavity and causing a significant midline shift.
Findings:
- A cystoperitoneal shunt was surgically placed to manage the large arachnoid cyst.
- Post-operatively, the cyst dimensions decreased, and there was a notable reexpansion of the compressed brain parenchyma.
Implications:
- Cystoperitoneal shunting presents a viable and effective treatment for massive intracranial arachnoid cysts in infants.
- This approach demonstrates a favorable risk-benefit profile, suggesting it as a primary management strategy for such rare pediatric neurosurgical conditions.
Abstract:
Intracranial arachnoid cysts are developmental anomalies that are generally asymptomatic. We describe a 6-month-old boy with macrocephaly but normal neurological development who was found to have a rare, massive basal arachnoid cyst occupying most of the cranium and extending superiorly, causing significant shift due to mass effect. A cystoperitoneal shunt was placed, producing both a decrease in the arachnoid cyst dimensions and a concomitant reexpansion of parenchyma. After consideration of various management options, such a shunt system appears to offer a low risk of complications and a high likelihood of success.