Wang P J, Lin H C, Liu H M, Tseng C L, Shen Y Z
Department of Pediatrics, National Taiwan University Hospital, Taipei.
Pediatr Neurol. 1998 Aug;19(2):100-4. doi: 10.1016/s0887-8994(98)00020-4.
Intracranial arachnoid cysts are benign development anomalies that may be clinically asymptomatic. The authors describe 30 children with intracranial arachnoid cysts in terms of clinical manifestations and relations to the associated brain anomalies or lesions. The mean age at onset of clinical manifestations was 4 years, 7 months (range 1 day to 14 years). The mean age at diagnosis was 6 years, 2 months (range 10 days to 16 years). Most patients with nonprogressive symptoms, such as seizures and headache, had focal epileptiform discharges on electroencephalogram, and they benefited from antiepileptic drugs. Surgery resulted in only partial reduction in both cyst size and seizure frequency in patients with intractable seizures, and it also failed to improve some neurologic signs, such as sexual precocity or cranial neuropathy resulting from long-term compression of arachnoid cysts. We conclude that the only absolute indication for surgery is the presence of progressive hydrocephalus or intracranial hypertension. The associated anomalies or lesions include brain tumors, giant nevocellular nevi, achondroplasia, microphthalmia, intracystic hemorrhage, dysgenesis of the corpus callosum, and heterotopia.
颅内蛛网膜囊肿是良性发育异常，可能临床上无症状。作者从临床表现以及与相关脑异常或病变的关系方面描述了30例患有颅内蛛网膜囊肿的儿童。临床表现出现的平均年龄为4岁7个月（范围1天至14岁）。诊断时的平均年龄为6岁2个月（范围10天至16岁）。大多数有非进行性症状（如癫痫发作和头痛）的患者脑电图上有局灶性癫痫样放电，且从抗癫痫药物治疗中获益。对于有难治性癫痫发作的患者，手术仅使囊肿大小和癫痫发作频率部分降低，并且也未能改善一些神经体征，如因蛛网膜囊肿长期压迫导致的性早熟或颅神经病变。我们得出结论，手术的唯一绝对指征是存在进行性脑积水或颅内高压。相关的异常或病变包括脑肿瘤、巨大先天性色素痣、软骨发育不全、小眼症、囊内出血、胼胝体发育不全和异位症。
