Surgical outcomes of congenital arachnoid cysts and their association with neurodevelopmental disorders.
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BACKGROUND: The aim of this study is to evaluate the surgical outcomes of arachnoid cyst decompression in patients less than 16 years of age with an associated neurodevelopmental disorder (NDD). METHODS: A retrospective analysis of surgically treated congenital arachnoid cyst within South Wales between 2010-2019. Surgical outcomes are measured according to clinical (Clinical Outcome Score [COG]) and radiological (Neuroimaging Outcome Score [NOG]) outcomes and the complication profiles are described. The association between arachnoid cysts and NDD both in South Wales and the literature review cohort is also discussed. RESULTS: The prevalence of congenital arachnoid cysts in South Wales is 0.02% and their association with neurodevelopmental disorders among patients with a congenital arachnoid cyst is high (estimated prevalence 19%). Eighteen (51%) in total were surgically treated in our unit; seven with an associated NDD. All surgical modalities showed improved clinical and radiological outcomes in those with an associated neurodevelopmental disorder, four (15%) patients who had endoscopic treatment, and two (7%) of those who underwent craniotomy had complications. No complications following cystoperitoneal shunt were seen. Four (21%) surgically treated patients were ultimately shunted following initial treatment by endoscopy or craniotomy. CONCLUSIONS: In a cohort of patients diagnosed with a congenital arachnoid cyst in association with a neurodevelopmental disorder, all surgical treatments show improved clinical and radiological outcomes. Cystoperitoneal shunting appears to have a favourable complication profile.