Congenital intracranial cysts account for a significant portion of intracranial lesions in the pediatric population. The efficiency of surgical treatment in a pediatric cohort with intracranial arachnoid cysts (ACs) at different locations regarding clinical symptoms and mass effect was evaluated.

A retrospective study of all children who underwent surgical treatment of an intracranial AC during an 11-year period (2007–2018) was performed. Demographics, clinical symptoms, and radiological cyst size pre- and postoperatively, as well as the reoperation rate and possible treatment complications, were analyzed.

A total of 116 intracranial cysts at 8 different anatomical locations were surgically treated in 113 children (median age 5 years and 10 months) predominantly by endoscopic technique (84%). The complication rate was 3%, and the reoperation rate was 16%. Preoperative cyst enlargement was significantly more common in infants (p < 0.0001), as was the need for reoperation (p = 0.023). After a median radiological follow-up of 26 months, > 50% reduction of cyst volume was seen in 53 cysts (46%), and 47 cysts (40%) showed a 10%–50% reduction. Acute clinical symptoms improved: nausea and vomiting, accelerated head growth, and headaches improved at 100%, 92% and 89%, respectively. However, chronic symptoms responded less favorably after a median clinical follow-up of 26 months.

The strategy of predominantly endoscopic treatment with navigation planning is efficient to alleviate clinical symptoms and to significantly reduce the mass effect of pediatric intracranial cysts at different anatomical locations. The subgroup of infants requires close pre- and postoperative monitoring.

先天性颅内囊肿占儿科人群颅内病变的很大一部分。评估了在不同位置的颅内蛛网膜囊肿 (ACs) 儿童队列中手术治疗的临床症状和占位效应的效率。

对所有在 11 年期间（2007-2018 年）接受颅内 AC 手术治疗的儿童进行了回顾性研究。分析了前后的人口统计学、临床症状和放射学囊肿大小，以及再手术率和可能的治疗并发症。

在 113 名儿童（中位年龄 5 岁零 10 个月）中，主要通过内窥镜技术 (84%) 对 8 个不同解剖位置的总共 116 个颅内囊肿进行了手术治疗。并发症发生率为3%，再手术率为16%。术前囊肿增大在婴儿中明显更常见（p < 0.0001），再次手术的需要（p = 0.023）也是如此。中位放射学随访 26 个月后，53 个囊肿 (46%) 的囊肿体积减少了 50% 以上，47 个囊肿 (40%) 减少了 10%–50%。急性临床症状改善：恶心和呕吐、头部生长加速、头痛分别改善100%、92%和89%。然而，中位临床随访 26 个月后，慢性症状的反应较差。

以导航规划为主的内镜治疗策略可有效缓解临床症状并显着降低不同解剖位置的小儿颅内囊肿的占位效应。婴儿亚组需要密切的术前和术后监测。