Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
Acta Neurochir (Wien). 2024 May 22;166(1):226. doi: 10.1007/s00701-024-06120-z.
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.
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).
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.
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.
近年来，人们对儿童颞叶蛛网膜囊肿（temporal arachnoid cysts）的临床意义进行了重新评估。这些囊肿通常被认为是无症状的，或者如果有症状，也只会引起局灶性神经症状或颅内压增高的迹象。然而，最近有几项研究报告称，手术后认知症状有所改善。本研究旨在评估儿童颞叶蛛网膜囊肿手术后报告的认知改善是否在五年后仍保持稳定。
连续评估了 10 名接受微神经外科开窗术治疗颞叶蛛网膜囊肿的儿童（m=14.65；范围 12.1-19.415）的认知功能，术后五年进行评估。结果与术前和术后评估进行比较。评估包括韦氏量表、波士顿命名测试（BNT）、 Rey 听觉言语学习测试（RAVLT）、言语流畅性测试（FAS）和 Rey 复杂图形测试（RCFT）。
分析显示，与基线相比，术后在韦氏量表的一般智力（FSIQ）、言语能力（VCI）和加工速度（PSI）方面有显著改善。术后平均差异为 FSIQ 8.3（p=0.026），VI 8.5（p<0.01）和 PSI 9.9（p=0.03）。将术后评分与术后五年的评分进行比较时，测试结果的平均值没有差异，表明改善具有长期稳定性。
结果表明，儿童颞叶蛛网膜囊肿手术后受影响的认知功能得到改善，且五年后仍保持稳定。改善情况和长期稳定性也与家长和儿童的经验一致。这些发现为儿童颞叶蛛网膜囊肿的神经外科开窗术提供了有力的论据。
