gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Suprasellar arachnoid cyst without hydrocephalus in the neonatal patient : treatment strategy and follow-up

Suprasellńre Arachnoidalzyste ohne Hydrozephalus beim Neugeborenen : Therapiestrategie und Verlauf

Meeting Abstract

  • corresponding author A. J÷dicke - Department of Neurosurgery, University Medical Centre, Gie▀en
  • A. Hilgendorff - Department of Neonatology, University Medical Centre, Gie▀en
  • A. Hahn - Department of Neuropaediatrics, University Medical Centre, Gie▀en
  • M. Krause - Department of Neurosurgery, University Medical Centre, Gie▀en
  • W. Scharbrodt - Department of Neurosurgery, University Medical Centre, Gie▀en
  • D.-K. B÷ker - Department of Neurosurgery, University Medical Centre, Gie▀en

Deutsche Gesellschaft fŘr Neurochirurgie. SociÚtÚ Franšaise de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft fŘr Neurochirurgie e.V. (DGNC), 3Ŕmes journÚes franšaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. DŘsseldorf, K÷ln: German Medical Science; 2005. DocP139

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0407.shtml

Published: May 4, 2005

© 2005 J÷dicke et al.
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Outline

Text

Objective

Suprasellar arachnoid cysts as para-ventricular space-occupying lesions in neonates are very rare. Indication for and optimal timing of surgical interventions are discussed.

Methods

In 7 children with suprasellar cysts treated within 5 years, one case of neonatal cyst occurred. Due to preterm labour, twins were delivered by caesarean section at GW 38. The twin concerned was initially stable (Apgar 9-9-10, BW 2200g, HR 105/min, resp. rate 50/min). US imaging performed due to an increased rate of apnoeic spells within the first week of age revealed a huge suprasellar cyst (40ml) with brainstem compression but without ventricular enlargement. Spells were initially treated with caffeine-citrate, however feeding abilities did not develop accordingly. MRI delineated the cyst with right-sided contact to the frontal convexity.

Results

Because of disturbed feeding, the cyst was fenestrated by a fronto-lateral approach at day 13. Respiration and feeding abilities normalized after another week without medication. Recurrent cyst formation and ventricular dilatation necessitated re-fenestration at 16 weeks of age (endoscopic ventriculo-cysto-cisternostomy). 12 months follow-up shows normal development with reduced cyst size in MRI.

Conclusions

Staged surgical procedures adapted to the clinical picture and surgical options may lead to a successful control of cysts even in the neonatal patient.