Clinical analysis of rupture of intracranial arachnoid cysts in children: a report of 29 cases

Objective To explore the clinical characteristics and treatments of rupture of intracranial arachnoid cyst (IAC) in children. Methods Retrospective analysis was conducted for clinical data of IAC rupture (n=29) and re-rupture (n=4), from January 2010 to January 2017. Treatments and prognoses were analyzed for different types of IAC rupture. There were 23 boys and 6 girls with an average age of (5.82±3.82) years. There was a definite history of trauma (n=17, 58.6%). And there were symptoms of intracranial hypertension (n=27, 93.1%). According to the imaging studies, cranial fossa was common (93.1%). IAC rupture was divided into subdural hygroma/ hemorrhage (n=22), subdural hematoma (n=4), intracystic bleeding (n=1) and intracystic & subdural hemorrhage (n=2). Treatments included conservative measures (n=8), burr hole (n=15), fistulization (n=4) and craniotomy hematoma clearance (n=5). Results Follow-ups were available for 27 children. The score of Karnofsky performance status (KPS) was 90-100 points. Some cases had mild symptoms and effusion/hematoma became absorbed completely (n=7), significantly less (n=9), less (n=6) and slightly more (n=5). And arachnoid cysts disappeared (n=6), significantly less (n=5), shrank (n=9) and remained unchanged (n=7). Conclusions Treatment of IAC rupture should be comprehensive evaluated by clinical symptoms and imaging data. For intracranial hypertension: with bleeding, burr hole drainage or craniotomy hematoma clearance may be selected. Without bleeding, fistulization with priority. Key words: Child; Arachnoid cysts; Subdural effusion; Hematoma, subdural