Cognition in children with arachnoid cysts – A five-year follow-up after microneurosurgical fenestration

• Published in: Acta neurochirurgica Vol. 166; no. 1; p. 226
• Main Authors: Adolfsson, Tomas, Edström, Erik, Tedroff, Kristina, Sandvik, Ulrika
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 22.05.2024; Springer Nature B.V
• Subjects: Adolescent; Arachnoid; Arachnoid Cysts - surgery; Auditory discrimination learning; Brain diseases; Child; Children; Cognition - physiology; Cognitive ability; Cysts; Female; Follow-Up Studies; Humans; Information processing; Interventional Radiology; Male; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Microsurgery - methods; Minimally Invasive Surgery; Neurology; Neuropsychological Tests - statistics & numerical data; Neuroradiology; Neurosurgery; Neurosurgical Procedures - methods; Original; Original Article; Pediatric Neurosurgery; Surgery; Surgical Orthopedics; Temporal lobe; Temporal Lobe - surgery; Treatment Outcome; Young Adult; Cognition; Arachnoid cysts; Children; Neurosurgery; Long term follow-up
• ISSN: 0942-0940; 0001-6268; 0942-0940
• DOI: 10.1007/s00701-024-06120-z

Background and Purpose In recent years there has been a re-evaluation regarding the clinical implications of temporal lobe arachnoid cysts (temporal arachnoid cysts) in children. These cysts have often been considered asymptomatic, or if symptomatic, only causing focal neurological symptoms or signs of increased intracranial pressure. However, several studies have more recently reported on cognitive symptoms improving after surgery. This study aimed to evaluate if reported cognitive improvement after surgery of temporal arachnoid cysts were stable after five years. Method Ten consecutive children (m = 14.65; range 12.1–19.415 were assessed cognitively five years after micro-neurosurgical fenestration of a temporal arachnoid cyst. Results were compared to results from their pre- and post-surgical evaluations. Evaluations included the Wechsler-scales, Boston Naming Test (BNT), Rey Auditory Verbal Learning Test (RAVLT), verbal fluency test (FAS) and Rey Complex Figure Test (RCFT). Results The analysis revealed significant postsurgical improvement compared to baseline on the Wechsler-scales measures of general intelligence (FSIQ), verbal abilities (VCI) and processing speed (PSI). Mean differences after surgery were 8.3 for FSIQ, (p = 0.026), 8.5 for VI (p =  < .01) and 9.9 for PSI (p = 0.03). There were no significant differences in mean test results when comparing postsurgical scores with scores five years after surgery, indicating long-term stability of improvements. Conclusion The results indicate that affected cognitive functions in children with temporal arachnoid cysts improve after surgery and that the improvements remain stable five years later. The improvements and long term stability were also consistent with the experience of both parents and children. The findings provide a strong argument for neurosurgical fenestration of temporal arachnoid cysts in children.