دورية أكاديمية
Staged neurosurgical approach for giant and progressive neonatal arachnoid cysts: a case series and review of the literature.
| العنوان: | Staged neurosurgical approach for giant and progressive neonatal arachnoid cysts: a case series and review of the literature. |
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| المؤلفون: | Peraud A; Division of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. aurelia.peraud@uniklinik-ulm.de., Schuler-Ortoli M; Division of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany., Schaal M; Department of Radiology, University Hospital Ulm, Ulm, Germany., Reister F; Section Obstetrics & Perinatology, Department of Obstetrics & Gynecology, University Hospital Ulm, Ulm, Germany., Ehrhardt H; Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics and Adolescent Medicine, University Hospital Ulm, Ulm, Germany., Friebe-Hoffmann U; Section Obstetrics & Perinatology, Department of Obstetrics & Gynecology, University Hospital Ulm, Ulm, Germany. |
| المصدر: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Jul; Vol. 40 (7), pp. 1997-2007. Date of Electronic Publication: 2024 Apr 11. |
| نوع المنشور: | Journal Article; Case Reports; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8503227 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-0350 (Electronic) Linking ISSN: 02567040 NLM ISO Abbreviation: Childs Nerv Syst Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1985- |
| مواضيع طبية MeSH: | Arachnoid Cysts*/surgery , Arachnoid Cysts*/diagnostic imaging , Neurosurgical Procedures*/methods, Female ; Humans ; Infant, Newborn ; Pregnancy ; Prenatal Diagnosis/methods |
| مستخلص: | Objectives: Prenatally diagnosed complex arachnoid cysts are very rare. While the true prenatal incidence is still unknown, they account for approximately 1% of intracranial masses in newborns. They rarely exhibit rapid growth or cause obstructive hydrocephalus, but if they increase to such a dimension during pregnancy, the ideal management is not well established. We present our detailed perinatal experience, covering prenatal diagnosis, a compassionate delivery process, and neonatal stabilization. Finally, a thorough postnatal neurosurgical intervention was performed. Initially, our focus was on the gradual reduction of cyst size as a primary effort, followed by subsequent definitive surgical treatment. Methods: This case series shows the treatment course of three fetuses with antenatally diagnosed large arachnoid cysts. We present pre- and postnatal management and imaging, as well as the surgical treatment plan and the available clinical course during follow-up. Results: Two girls and one boy were included in the current review. All three cases presented with prenatally diagnosed complex arachnoid cysts that increased in size during pregnancy. The mean gestational age at delivery was 35 weeks (range 32 to 37 weeks), and all patients were delivered by a caesarian section. Increasing head circumference and compression of brain structures were indications for delivery, as they are associated with a high risk of excess intracranial pressures and CSF diapedesis, as well as traumatic delivery and maternal complications. All cysts were supratentorial in location; one expanded into the posterior fossa, and one was a multicompartment cyst. All children underwent an initial surgical procedure within the first days of life. To relieve cyst pressure and achieve a reduction in head circumference, an ultrasound-guided or endoscopic-assisted internal shunt with drainage of the cyst to the ventricles or subdural/subarachnoid space was inserted. Definite surgical therapy consisted of cyst marsupialization and/or cysto-peritoneal shunt implantation. All children survived without severe neurodevelopmental impairments. Conclusion: With the cases presented, we demonstrate that the slow reduction of immense cyst size as an initial procedure until optimal requirements for final surgical treatment were achieved has proven to be optimal for neurological outcome. Special emphasis has to be taken on the delicate nature of premature newborn babies, and surgical steps have to be thoroughly considered within the interdisciplinary team. (© 2024. The Author(s).) |
| References: | World Neurosurg. 2013 Feb;79(2 Suppl):S20.e1-7. (PMID: 22381822) J Ultrasound Med. 2010 Oct;29(10):1487-93. (PMID: 20876904) Fetal Diagn Ther. 2016;40(1):1-12. (PMID: 27105003) J Prenat Med. 2009 Apr;3(2):28-30. (PMID: 22439038) Br J Neurosurg. 1999 Feb;13(1):10-7. (PMID: 10492679) Case Rep Pediatr. 2016;2016:5493769. (PMID: 27891281) Surg Neurol Int. 2021 Dec 20;12:621. (PMID: 34992937) J Neurosurg Pediatr. 2010 Jun;5(6):578-85. (PMID: 20515330) Fetal Diagn Ther. 2008;24(4):385-8. (PMID: 18957852) Childs Nerv Syst. 2000 Nov;16(10-11):619-26. (PMID: 11151710) Surg Neurol Int. 2018 Mar 07;9:57. (PMID: 29576908) Adv Exp Med Biol. 2012;724:37-50. (PMID: 22411232) J Obstet Gynaecol. 2007 Jan;27(1):83-5. (PMID: 17365470) Childs Nerv Syst. 1992 Aug;8(5):281-6. (PMID: 1394268) Prenat Diagn. 2009 Nov;29(11):1078-80. (PMID: 19688781) J Matern Fetal Neonatal Med. 2022 Dec;35(24):4728-4733. (PMID: 33397177) Neurochirurgie. 2022 Dec;68(6):679-683. (PMID: 35907443) Eur J Paediatr Neurol. 2015 Mar;19(2):114-21. (PMID: 25599983) J Neurosurg Pediatr. 2021 Aug 20;28(5):544-552. (PMID: 34724647) Eur J Radiol. 2019 Apr;113:232-237. (PMID: 30927952) Ultrasound Obstet Gynecol. 2012 Jun;39(6):625-31. (PMID: 22173885) Surg Neurol. 1982 May;17(5):363-9. (PMID: 7089853) Neurosurgery. 2016 Mar;78(3):370-9; discussion 379-80. (PMID: 26445374) Neurosurg Rev. 2022 Oct;45(5):3171-3178. (PMID: 35657443) Childs Nerv Syst. 2022 Sep;38(9):1813-1816. (PMID: 35532779) |
| فهرسة مساهمة: | Keywords: Arachnoid cysts; MRI; Neurosurgery; Prenatally diagnosed complex arachnoid cysts |
| تواريخ الأحداث: | Date Created: 20240411 Date Completed: 20240615 Latest Revision: 20240621 |
| رمز التحديث: | 20240621 |
| مُعرف محوري في PubMed: | PMC11180026 |
| DOI: | 10.1007/s00381-024-06385-w |
| PMID: | 38602531 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1433-0350 |
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| DOI: | 10.1007/s00381-024-06385-w |