Predictors for the clinical prognosis of sylvian arachnoid cysts in children

OBJECTIVES: To investigate the potential factors affecting the clinical prognosis of intracranial sylvian arachnoid cysts(IAC) in children. METHODS: All patients with IAC admitted to our department from January, 1, 2015 to December, 31, 2016, were retrospectively reviewed. Patients were grouped based on surgical treatment (surgery cohort vs non-surgery cohort). The clinical and image outcome of the patients were followed routinely. The clinical characteristics and the prognosis of the patients were compared in different cohorts. Binary logistic regression analysis was applied to analyze the potential factors which may post an influence on the prognosis of the patients. RESULTS: Of 500 patients admitted to our department for IAC, 424 patients had good prognosis and 76 had poor prognosis, with no deaths occurred during the follow-ups. 68 patients had IAC related complications and 91 patients developed new symptoms during the follow-ups. There were significant differences (P < 0.05) between the 2 cohorts in below aspects: age, gender, Galassi subtype, whether the mother was a unipara, the maximum diameter of the cysts at the first visit and the last follow-up, headache, head circumference, temporal bulge, new symptoms, cysts rupture and hemorrhage, subdural effusion, and IAC disappearance. The mean changes in the maximum diameter of the IAC for the patients were marginally higher for the surgery cohort than for the non-surgery cohort (P < 0.01). Binary logistic regression analysis suggested that the number of symptom, no new symptoms during follow-up, surgical treatment, age, maximum diameter of cysts at first diagnosis were independent risk factors affecting the prognosis of patients (P < 0.05). CONCLUSIONS: Patients older than 22.5 months, with the maximum diameter of IAC greater than 5.75 cm, who have multiple symptoms, born prematurely, develope new symptoms during the follow-ups and obvious symptoms after trauma need to conduct necessary surgical treatment in time. Patients with complications such as cysts rupture with hemorrhage and subdural effusion will acquire good prognosis after timely surgical treatment. IAC complete disappearance warrants no such important attention for the good prognosis.