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Clinical Evaluation of the Arachnoid Cysts in the Pediatric Age Group.

Journal of the Korean Pediatric Society 1988;31(4):467-473.
Published online April 30, 1988.
Clinical Evaluation of the Arachnoid Cysts in the Pediatric Age Group.
Ho Taek Kim, Young Hyuk Lee, Chang Jun Coe
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
소아영역의 뇌지주막낭종에 대한 임상적 고찰
김호택, 이영혁, 고창준
연세대학교 의과대학 소아과학교실 장애아동 연구소
Received: 23 July 1987   • Accepted: 30 November 1987
Abstract
Arachnoid cysts are benign cysts occuring in the cerebrospinal axis in relation to the arachnoid membrane. From Jan, 1974 unitl June, 1986. we evaluated the clinical features and outcome of the arachnoid cyst by the review of the medical records and followup study of 20 cases in pediatric age group, and the results are as follows: 1) The age distribution of the patients was from 2 months afte birth to 15 years of age, and the mean age was 4.1+4.5 (mean+S.D.) years. 2) 50% (10 cases) of the patients had occurred the first symptom before 1 year of age. 3) Male was more frequently involved than female by the ratio of 3:1. 4) Epileptic seizure was the most common subjective neurologic symptom at the time of visiting hospital (45%), and headache was the symptom of second incidence (40%), Another presenting symptoms were vomiting (20%), developmental delay (15%), hemiparesis (10%), macrocephaly (10%), and learning disability (5%). 5) The sites of the arachnoid cysts were temporal area by 85% and posterior fossa by 15%, and the location of the right to left differences had no statistical significance. 6) Electroencephalography (EEG) was done to 9 patients, which of 7 cases experienced epileptic seizure, but 2 cases did not have seizure activity. And all cases showed abnormal EEG waves. 7) The total outcome of the patients were followed-up and the rate of much improved patietns was 45% (9 cases). 9 patients had got medical treatment only (group A), and 11 cases were operated surgically after medical treatment (group B). In group A, the rate of much improved patients was 55. 6% and in group B, it was 36.4%. However, we could not agree that the outcome of group A was superior to that of surgically treated group, because the patients of group A were operated surgically after the failure of medical treatment. 8) Three methods of operation (1) single burr hole drainage, (2) cystoperitioneal shunt operation, (3) removal of the cyst after craniotomy were used. And there were no statisically significant differences for the outcome among the three methods of operation.
Key Words: Arachnoid cyst, Pediatric age group


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