Research ArticleOpen Access

3D Modeling for Comparison of Surgically Treated Intracranial Arachnoid Cysts in Children

Volume 8 - Issue 5

Jacqueline Boyle BS, Anthony Avellino and Julian Lin*

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- Department of Neurosurgery, University of Illinois College of Medicine at Peoria, USA
*Corresponding author: Julian Lin, Department of Neurosurgery, University of Illinois College of Medicine at Peoria,530 NE Glen Oak Avenue, Peoria IL 61637, USA

Received: August 23, 2018; Published: September 07, 2018

DOI: 10.26717/BJSTR.2018.08.001705

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Abstract

Object: Arachnoid cysts (AC) are benign, fluid-filled lesions of the arachnoid membrane accounting for approximately 1% of intracranial lesions. We utilized 3D volumetric measurement techniques to evaluate AC volumetric changes with open craniotomy or endoscopic approach for cyst fenestration in pediatric patients, focusing on correlation with patient age, clinical features, and surgical outcomes.

Methods: Pediatric patients (≤18 years old) with AC who had undergone treatment with open craniotomy or endoscopic approach for AC fenestration were identified from medical records. The volume of the intracranial AC were modeled before and after surgical intervention with Brain Lab software.

Results: Nineteen patients (3 females and 16 males) were included (mean age 6.5±5.5 years; range 0-18 years). The patients were distributed into three groups based on age: 0-3 years, 3.5-8 years, ≥9 years. Comparison of both pre- and post-operative volumes demonstrated no statistical difference between age groups, but evaluation of percent change between pre- and post-operative volumes revealed statistically significant greater decrease in volume reduction in both older age groups (3.5-8 years and ≥9 years) compared to the youngest age group (0-3 years). There was a trend toward increased improvement/resolution of presenting clinical symptoms with increasing age (p=0.01). Subdural hematoma was found to be statistically lower in the 3-8 years group (p=0.03-0.05). Shunt placement was found to be statistically highest in the youngest age group (p=0.03).

Conclusion: 3D modeling of surgically treated AC in children provides a consistent quantitative measure to evaluate AC changes over time. Utilizing comparison by age, this study finds significantly greater decreases in cyst volume and greater post-surgical symptom improvement/resolution with cyst fenestration in older pediatric patients, suggesting support for surgical intervention in these patients. In young children, especially infants, changes in CSF dynamics result in minimal cyst decrease following fenestration and a significant role for shunts.