Document Detail

Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case-control study.
MedLine Citation:
PMID:  23313978     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: As the availability of imaging modalities has increased, the finding of arachnoid cysts has become common. Accurate patient counseling regarding physical activity or risk factors for cyst rupture or hemorrhage has been hampered by the lack of definitive association studies.
OBJECTIVE: This case-control study evaluated factors that are associated with arachnoid cyst rupture (intracystic hemorrhage, adjacent subdural hematoma, or adjacent subdural hygroma) in pediatric patients with previously asymptomatic arachnoid cysts.
METHODS: Patients with arachnoid cysts and intracystic hemorrhage, adjacent subdural hygroma, or adjacent subdural hematoma treated at a single institution from 2005 to 2010 were retrospectively identified. Two unruptured/nonhemorrhagic controls were matched to each case based on patient age, sex, anatomical cyst location, and side. Risk factors evaluated included arachnoid cyst size, recent history of head trauma, and altitude at residence.
RESULTS: The proportion of imaged arachnoid cysts that presented either originally or subsequently with a rupture or hemorrhage was 6.0%. Larger cyst size, as defined by maximal cyst diameter, was significantly associated with cyst rupture/hemorrhage (P < .001). When dichotomized with a 5-cm cutoff, 9/13 larger cysts ruptured and/or hemorrhaged, whereas only 5/29 smaller cysts ruptured/hemorrhaged (odds ratio = 16.5 (confidence interval [2.5, ∞]). A recent history of head trauma was also significantly associated with the outcome (P < .001; odds ratio = 25.1 (confidence interval [4.0, ∞]). Altitude was not associated with arachnoid cyst rupture or hemorrhage.
CONCLUSION: This case-control study suggests that larger arachnoid cyst size and recent head trauma are risk factors for symptomatic arachnoid cyst rupture/hemorrhage.
Marshall Cress; John R W Kestle; Richard Holubkov; Jay Riva-Cambrin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  72     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-19     Completed Date:  2013-11-04     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  716-22; discussion 722     Citation Subset:  IM    
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MeSH Terms
Arachnoid Cysts / epidemiology*,  radiography*
Case-Control Studies
Cerebral Angiography / statistics & numerical data*
Cerebral Hemorrhage / epidemiology*,  radiography*
Risk Factors
Rupture / epidemiology,  radiography
Treatment Outcome
Utah / epidemiology
Comment In:
Neurosurgery. 2014 Jan;74(1):E150-3   [PMID:  24193361 ]
Neurosurgery. 2014 Jan;74(1):E153-4   [PMID:  24064487 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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