Management of pediatric quadrigeminal arachnoid cysts: a systematic review and illustrative case report.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Emmanuel K Adjei Osei, Kwadwo Darko, Pearl Tenkorang, Maame A D Boateng, Nana A B O Sekyere, Bernice Limann, Oluruntoba Ogunfolaji, Sean O'Leary, Umaru Barrie, Teddy Totimeh
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Abstract

Introduction: Quadrigeminal arachnoid cysts (QACs) are often incidental but may present with compressive symptoms on surrounding brain structures. This study evaluates management strategies and outcomes in the literature and highlights the feasibility and importance of neuroendoscopic treatment in resource-limited settings using an illustrative case.

Methods: Our systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Google Scholar, Embase, and SCOPUS databases to identify and assess primary articles exploring pediatric QAC cases. Additionally, we present an illustrative case report.

Results: We identified 32 articles for analysis. Males constituted 57.4% (128/223) of cases. Most patients (98.1%, 208/212) were symptomatic. Common symptoms included macrocephaly (49.6%, 117/236) and hydrocephalus (24.5%, 56/229). Endoscopic approaches included ETV alone (7.1%, 15/211), ETV with cyst fenestration (ETV/CF) (28%, 59/211), and cyst fenestration alone (13.7%, 29/211). Cyst reduction was achieved in 80.5% (136/169) of cases. Postoperative cyst recurrence was low (1.3%, 3/226), as were complications such as intraoperative bleeding (1.9%, 3/159) and infections (drain infection, 1.9%; meningitis, 0.6%). The mortality rate was 1.3% (3/237). VP shunting (16.3%, 22/135) and ETV (8.9%, 12/135) were the most common reintervention procedures.

Conclusion: ETV-only and ETV/CF are reasonable options in the surgical management of QACs, with reported low rates of complications and comparable reintervention rates. Although access to neuroendoscopy is limited in the subregion, this review and illustrative case report shed light on the potential impact neuroendoscopy can have on the care of such cases.

小儿四叉神经蛛网膜囊肿的处理:系统回顾和说明性病例报告。
简介:四叉神经蛛网膜囊肿(QACs)通常是偶然发生的,但可能表现为周围脑结构的压迫症状。本研究评估了文献中的管理策略和结果,并使用一个说明性病例强调了在资源有限的情况下神经内窥镜治疗的可行性和重要性。方法:我们的系统评价是根据系统评价和荟萃分析指南的首选报告项目进行的,使用PubMed、谷歌Scholar、Embase和SCOPUS数据库来识别和评估探讨儿科QAC病例的主要文章。此外,我们提出了一个说明性的案例报告。结果:我们筛选出32篇文章进行分析。男性占57.4%(128/223)。大多数患者(98.1%,208/212)有症状。常见症状包括大头畸形(49.6%,117/236)和脑积水(24.5%,56/229)。内镜入路包括单纯ETV(7.1%, 15/211)、ETV合并囊肿开窗(ETV/CF)(28%, 59/211)和单纯囊肿开窗(13.7%,29/211)。80.5%(136/169)的病例实现了囊肿缩小。术后囊肿复发率低(1.3%,3/226),术中出血(1.9%,3/159)和感染(引流管感染,1.9%;脑膜炎,0.6%)。死亡率为1.3%(3/237)。VP分流(16.3%,22/135)和ETV(8.9%, 12/135)是最常见的再干预手术。结论:单纯ETV和ETV/CF是QACs手术治疗的合理选择,并发症发生率低,再干预率相当。尽管在该次区域获得神经内窥镜检查的机会有限,但本综述和说明性病例报告揭示了神经内窥镜检查可能对此类病例的护理产生的潜在影响。
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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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