Individualized Surgical Treatment Strategy of Pediatric Middle Cranial Fossa Arachnoid Cyst Associated with Chronic Intracranial Hematoma

Objective To investigate the surgical treatment strategy of pediatric middle cranial fossa arachnoid cyst associated with chronic intracranial hematoma. Methods 13 cases of clinical data of pediatric middle cranial fossa arachnoid cyst associated with chronic intracranial hematoma were retrospectively analyzed. All cases were classified into 2imaging types as follows:intracystic type and subdural type. Individualized surgical treatment strategy was taken according to the imaging characteristics(including the imagical type,cyst size,midline shift)and factors such as age,clinical manifestation,and then evaluated the curative effect. Results After operation,the clinical symptoms of 13 cases were disappeared,and there were no infection,acute intracranial hemorrhage and death. The follow-up period ranged from 3months to 8years. 7cases of intracystic type in postoperative,a total of 5cases of cyst shrink different level(disappeared in 2cases,2cases of50%smaller and 1case of20%smaller),the other 2cases had not changed. 6cases of postoperative subdural type,2cases of cyst shrink 50%,there were no changes in the other 4cases of cyst. Only one case with intracystic type had bilateral subdural hematoma recurrence ten months later. Conclusion Comprehensive evaluation between the hematoma and cyst imaging characteristics(including the type of imaging,the cyst size,midline shift,etc.),combined with the factors such as age,clinical manifestation,must be helpful to individual choices in pediatric middle cranial fossa arachnoid cyst with chronic intracranial hematoma surgical treatment strategy.