Temporosylvian arachnoid cysts in children. Part 1: Cognitive profile of children with a temporal cyst and impact of the cyst in daily life. A prospective study in 100 consecutive children

View More View Less
  • 1 Service de Neurochirurgie, Hôpital universitaire Necker, AP-HP, Paris, France;
  • | 2 INSERM UMR 1018-CESP, Universités Paris-Saclay, UVSQ, Villejuif, France;
  • | 3 Faculté de Médecine, Université de Paris, France;
  • | 4 Institut universitaire de France, Paris, France;
  • | 5 Laboratoire Mémoire, Cerveau et Cognition, Institut de Psychologie, Université de Paris; INSERM UMR S894, Paris, France; and
  • | 6 Service de Neurochirurgie, Centre Hospitalier Universitaire de Fort de France, Université des Antilles, Fort-de-France, Martinique
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $45.00
USD  $515.00
USD  $612.00
Print or Print + Online Sign in

OBJECTIVE

The aim of this study was to determine the cognitive profile of children with a temporal arachnoid cyst (TAC) and its impact on daily life.

METHODS

The authors prospectively analyzed the cognitive and psychological profiles of 100 consecutive children relative to age and cyst characteristics (side, cyst size, and cyst shape: convex or nonconvex) and their outcome 4 years later.

RESULTS

Mean IQs were normal but with high heterogeneity on Full Scale IQ (FSIQ; range 59–150); 29% of children had at least one Wechsler index below the norm, in particular, Processing Speed and Working Memory Indexes. Impairments were observed in language for 31% of children, as well as in verbal memory (28%), visual memory (23%), executive function (21%), and visual attention (24%). Half of the children (50%) needed rehabilitation for learning difficulties, and 26% had academic difficulties. The parental questionnaire BRIEF (Behavior Rating Inventory of Executive Function) revealed significant executive dysfunctions in daily life for 22% of the children. One-third of the patients (34%) required psychotherapy for anxiety or social disorders, with higher rates in patients with a right-sided cyst and older children. Cyst size had very little neuropsychological impact. Convex cysts were significantly associated with worse performance than nonconvex cysts on all Wechsler indexes and FSIQ, and in language, verbal memory, attention, and visuospatial skills. Children with a convex cyst had significantly more executive and behavior difficulties in daily life and more psychotherapy than other children. The effect of cyst shape was independent of Galassi type and cyst side. Children with a ruptured cyst or an incidentally discovered cyst usually had a good cognitive level. Four years later, children without initial disorders remained stable, whereas those with difficulties who did not undergo surgery needed more rehabilitation and school adaptations.

CONCLUSIONS

This large cohort study revealed a varied profile of children with a TAC: at initial assessment, 50% had neuropsychological difficulties and needed rehabilitation and/or psychotherapy for learning or behavior difficulties, and 50% had no difficulties, which may explain the debate about this pathology. Patients with neuropsychological difficulties had a heterogeneous profile with normal intelligence but selective cognitive and/or behavior disorders that may have a long-term impact on their quality of life, particularly those with a right-sided cyst. A neuropsychological evaluation is not always necessary for a cyst discovered incidentally, but early evaluation is essential in patients with academic, learning, or psychological disorders. When assessment shows selective disorders presumably linked to cyst location, surgery may be considered, particularly for convex cysts, as this study revealed more effects in association with cyst shape than with cyst size and significantly poorer performance with a convex cyst.

ABBREVIATIONS

BRIEF = Behavior Rating Inventory of Executive Function; CBCL = Child Behavior Checklist; CDI = Children’s Depression Inventory; FSIQ = Full Scale IQ; ICP = intracranial pressure; TAC = temporal arachnoid cyst; TMT-B = Trail Making Test Part B; WISC-IV = Wechsler Intelligence Scale for Children–IV.

Supplementary Materials

    • Supplemental Table 1 (PDF 460 KB)

Images from Oushy et al. (pp 195–202).

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $515.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
USD  $515.00
USD  $612.00
  • 1

    Bright R. Serous cysts in the arachnoïd. In: Reports of Medical Cases, Selected with a View of Illustrating the Symptoms and Cure of Diseases by a Reference to Morbid Anatomy. Volume 2: Diseases of the Brain and Nervous System. Longman, Rees, Orme, Brown, Paternoster-Row and S Highley, London;1831:437439.

    • Search Google Scholar
    • Export Citation
  • 2

    Morris Z, Whiteley WN, Longstreth WT Jr, et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2009;339:b3016.

  • 3

    Di Rocco C. Sylvian fissure arachnoid cysts: we do operate on them but should it be done?. Childs Nerv Syst. 2010;26(2):173175.

  • 4

    Kunz U, Rückert N, Tägert J, Dietz H. Clinical and neuropsychological results after operative and conservative treatment of arachnoidal cysts of the perisylvian region. Acta Neurochir Suppl (Wien). 1988;42:216220.

    • Search Google Scholar
    • Export Citation
  • 5

    Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G. Infratentorial arachnoid cysts. J Neurosurg. 1985;63(2):210217.

  • 6

    Rabiei K, Hellström P, Högfeldt-Johansson M, Tisell M. Does subjective improvement in adults with intracranial arachnoid cysts justify surgical treatment?. J Neurosurg. 2018;128(1):250257.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Vaivre-Douret L, Boschi A, Cuny ML, et al. Left temporal arachnoid cyst and specific learning disorders associated with Pervasive Developmental Disorders - Not Otherwise Specified (PDD-NOS): contributions of an integrative neuropsychomotor, neuropsychological, psychopathological and neurosurgical approach about a case report in a child (François). Article in French. Encephale. 2016;42(6):582588.

    • Search Google Scholar
    • Export Citation
  • 8

    Kuhnley EJ, White DH, Granoff AL. Psychiatric presentation of an arachnoid cyst. J Clin Psychiatry. 1981;42(4):167168.

  • 9

    B Gjerde P, Schmid M, Hammar A, Wester K. Intracranial arachnoid cysts: impairment of higher cognitive functions and postoperative improvement. J Neurodev Disord. 2013;5(1):21.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10

    Gundersen H, Helland CA, Raeder MB, Hugdahl K, Wester K. Visual attention in patients with intracranial arachnoid cysts. J Neurol. 2007;254(1):6066.

  • 11

    Raeder MB, Helland CA, Hugdahl K, Wester K. Arachnoid cysts cause cognitive deficits that improve after surgery. Neurology. 2005;64(1):160162.

  • 12

    Soukup VM, Patterson J, Trier TT, Chen JW. Cognitive improvement despite minimal arachnoid cyst decompression. Brain Dev. 1998;20(8):589593.

  • 13

    Torgersen J, Helland C, Flaatten H, Wester K. Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB). J Neurol. 2010;257(11):19091916.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Tsurushima H, Harakuni T, Saito A, Tominaga D, Hyodo A, Yoshii Y. Symptomatic arachnoid cyst of the left frontal convexity presenting with memory disturbance—case report. Neurol Med Chir (Tokyo). 2000;40(6):339341.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15

    Wester K, Hugdahl K. Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement. J Neurol Neurosurg Psychiatry. 1995;59(3):293298.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    De Volder AG, Michel C, Thauvoy C, Willems G, Ferrière G. Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J Neurol Neurosurg Psychiatry. 1994;57(3):296300.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Laporte N, De Volder A, Bonnier C, Raftopoulos C, Sébire G. Language impairment associated with arachnoid cysts: recovery after surgical treatment. Pediatr Neurol. 2012;46(1):4447.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Matsuda W, Akutsu H, Miyamoto S, et al. Apparently asymptomatic arachnoid cyst: postoperative improvement of subtle neuropsychological impediment—case report. Neurol Med Chir (Tokyo). 2010;50(5):430433.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19

    Kwiatkowska K, Hałabuda A, Rybus J, Kwiatkowski S. Cognitive disorders in a patient with an arachnoid cyst of the sylvian fissure and improvement after surgical treatment: case description. Appl Neuropsychol Child. 2019;8(2):182186.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20

    Sandvik U, Adolfsson T, Jacobson DN, Tedroff K. Cognition in children with arachnoid cysts. J Clin Med. 2020;9(3):E850.

  • 21

    Agopian-Dahlenmark L, Mathiesen T, Bergendal Å. Cognitive dysfunction and subjective symptoms in patients with arachnoid cyst before and after surgery. Acta Neurochir (Wien). 2020;162(5):10411050.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    da Silva JA, Alves A, Talina M, Carreiro S, Guimarães J, Xavier M. Arachnoid cyst in a patient with psychosis: case report. Ann Gen Psychiatry. 2007;6(1):16.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    Gallassi R, Ciardulli C, Ferrara R, Lorusso S, Galassi E, Lugaresi E. Asymptomatic large arachnoid cyst of the middle cranial fossa. A clinical and neuropsychological study. Eur Neurol. 1985;24(2):140144.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Grindle CR, O’Reilly RC, Morlet T, Finden S. Central auditory processing deficiency with anatomic deficit in left superior temporal lobe. Laryngoscope. 2010;120(8):16711674.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Horiguchi T, Takeshita K. Cognitive function and language of a child with an arachnoid cyst in the left frontal fossa. World J Biol Psychiatry. 2000;1(3):159163.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Lebowitz BK, Schefft BK, Testa SM, Patton JA, Yeh HS. Neurocognitive sequelae of a giant arachnoid cyst: case study. Neurocase. 2006;12(6):339345.

  • 27

    Kim KH, Lee JY, Phi JH, Cho BK, Shin MS, Kim SK. Neurocognitive profile in children with arachnoid cysts before and after surgical intervention. Childs Nerv Syst. 2019;35(3):517522.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Zaatreh MM, Bates ER, Hooper SR, et al. Morphometric and neuropsychologic studies in children with arachnoid cysts. Pediatr Neurol. 2002;26(2):134138.

  • 29

    Park YS, Eom S, Shim KW, Kim DS. Neurocognitive and psychological profiles in pediatric arachnoid cyst. Childs Nerv Syst. 2009;25(9):10711076.

  • 30

    Schertz M, Constantini S, Eshel R, Sela AH, Roth J, Fattal-Valevski A. Neurodevelopmental outcomes in children with large temporal arachnoid cysts. J Neurosurg Pediatr. 2018;21(6):578586.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Spansdahl T, Solheim O. Quality of life in adult patients with primary intracranial arachnoid cysts. Acta Neurochir (Wien). 2007;149(10):10251032.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32

    Robertson SJ, Wolpert SM, Runge VM. MR imaging of middle cranial fossa arachnoid cysts: temporal lobe agenesis syndrome revisited. AJNR Am J Neuroradiol. 1989;10(5):10071010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, Frank G. CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol. 1982;17(5):363369.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Helland CA, Wester K. A population-based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in children. J Neurosurg. 2006;105(5)(suppl):385390.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    von Gontard A, Müller U. Psychiatric and neuropsychological symptoms in children with arachnoid cysts—a case report. Article in German. Z Kinder Jugendpsychiatr. 1991;19(1):3037.

    • Search Google Scholar
    • Export Citation
  • 36

    Fombonne E, Vermeersch S. Children of the GAZEL Cohort: I—Prevalence of contacts with the medico-educational system for psychological reasons, and associated factors. Article in French. Rev Epidemiol Sante Publique. 1997;45(1):2940.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    RERS. Repères et références statistiques. DEPP;2013.

  • 38

    Chevignard M, Kerrouche B, Krasny-Pacini A, et al. Ecological assessment of everyday executive functioning at home and at school following childhood traumatic brain injury using the BRIEF questionnaire. J Head Trauma Rehabil. 2017;32(6):E1E12.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Chiron C, Jambaque I, Nabbout R, Lounes R, Syrota A, Dulac O. The right brain hemisphere is dominant in human infants. Brain. 1997;120(Pt 6):10571065.

  • 40

    Hertz-Pannier L, Chiron C, Jambaqué I, et al. Late plasticity for language in a child’s non-dominant hemisphere: a pre- and post-surgery fMRI study. Brain. 2002;125(Pt 2):361372.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41

    Saitovitch A, Popa T, Lemaitre H, Rechtman E, Lamy JC, Grévent D, et al. Tuning eye-gaze perception by transitory STS inhibition. Cereb Cortex. 2016;26(6):28232831.

  • 42

    Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R. Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wien). 1992;119(1-4):6873.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43

    Schroeder HW, Gaab MR. Endoscopic observation of a slit-valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery. 1997;40(1):198200.

    • Search Google Scholar
    • Export Citation
  • 44

    Helland CA, Aarhus M, Knappskog P, et al. Increased NKCC1 expression in arachnoid cysts supports secretory basis for cyst formation. Exp Neurol. 2010;224(2):424428.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45

    Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J. Arachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg. 1984;60(4):803813.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46

    Cuny ML, Piolino P, Paternoster G, et al. Temporosylvian arachnoid cysts in children. Part 2: Postoperative neuropsychological and clinical improvement. J Neurosurg Pediatr. Published online May 20, 2022.doi: 10.3171/2021.11.PEDS21207

    • Search Google Scholar
    • Export Citation
  • 47

    De Agostini M, Dellatolas G. Une épreuve simple pour évaluer la préférence manuelle chez 1’enfant à partir de 3 ans. Enfance. 1988;41(3-4):139147.

    • Search Google Scholar
    • Export Citation
  • 48

    Kovacs M. The Children’s Depression Inventory (CDI). Psychopharmacol Bull. 1985;21(4):995998.

  • 49

    Achenbach TM. Manual for the Child Behavior Checklist 4-18 and 1991 Profile. University of Vermont;1991.

  • 50

    Gioia GA, Isquith PK, Guy SC, Kenworthy L. Behavior Rating Inventory of Executive Function. Psychological Assessment Resources;2000.

  • 51

    Cohen MJ. CMS—Echelle de mémoire pour enfants. Editions du Centre de Psychologie Appliquée; 2001.

  • 52

    Signoret JL. Batterie d’efficience mnésique (BEM 144). Elsevier Science Ltd;1991.

  • 53

    Jambaqué I, Dellatolas G. Épreuves de fluence verbale et de dénomination chez l’enfant d’âge scolaire. ANAE. 2000;56:1316.

  • 54

    Khomsi A. ELO: évaluation du langage oral. Editions du Centre de Psychologie Appliquée; 2001.

Metrics

All Time Past Year Past 30 Days
Abstract Views 1362 1362 355
Full Text Views 181 181 52
PDF Downloads 223 223 79
EPUB Downloads 0 0 0