The aim of this study was to determine the cognitive profile of children with a temporal arachnoid cyst (TAC) and its impact on daily life.

The authors prospectively analyzed the cognitive and psychological profiles of 100 consecutive children relative to age and cyst characteristics (side, cyst size, and cyst shape: convex or nonconvex) and their outcome 4 years later.

Mean IQs were normal but with high heterogeneity on Full Scale IQ (FSIQ; range 59–150); 29% of children had at least one Wechsler index below the norm, in particular, Processing Speed and Working Memory Indexes. Impairments were observed in language for 31% of children, as well as in verbal memory (28%), visual memory (23%), executive function (21%), and visual attention (24%). Half of the children (50%) needed rehabilitation for learning difficulties, and 26% had academic difficulties. The parental questionnaire BRIEF (Behavior Rating Inventory of Executive Function) revealed significant executive dysfunctions in daily life for 22% of the children. One-third of the patients (34%) required psychotherapy for anxiety or social disorders, with higher rates in patients with a right-sided cyst and older children. Cyst size had very little neuropsychological impact. Convex cysts were significantly associated with worse performance than nonconvex cysts on all Wechsler indexes and FSIQ, and in language, verbal memory, attention, and visuospatial skills. Children with a convex cyst had significantly more executive and behavior difficulties in daily life and more psychotherapy than other children. The effect of cyst shape was independent of Galassi type and cyst side. Children with a ruptured cyst or an incidentally discovered cyst usually had a good cognitive level. Four years later, children without initial disorders remained stable, whereas those with difficulties who did not undergo surgery needed more rehabilitation and school adaptations.

This large cohort study revealed a varied profile of children with a TAC: at initial assessment, 50% had neuropsychological difficulties and needed rehabilitation and/or psychotherapy for learning or behavior difficulties, and 50% had no difficulties, which may explain the debate about this pathology. Patients with neuropsychological difficulties had a heterogeneous profile with normal intelligence but selective cognitive and/or behavior disorders that may have a long-term impact on their quality of life, particularly those with a right-sided cyst. A neuropsychological evaluation is not always necessary for a cyst discovered incidentally, but early evaluation is essential in patients with academic, learning, or psychological disorders. When assessment shows selective disorders presumably linked to cyst location, surgery may be considered, particularly for convex cysts, as this study revealed more effects in association with cyst shape than with cyst size and significantly poorer performance with a convex cyst.

本研究的目的是确定患有颞叶蛛网膜囊肿 (TAC) 的儿童的认知特征及其对日常生活的影响。

作者前瞻性地分析了 100 名连续儿童的认知和心理特征，包括年龄和囊肿特征（侧面、囊肿大小和囊肿形状：凸面或非凸面）及其 4 年后的结果。

平均智商正常，但在全量表智商（FSIQ；范围 59-150）上具有高异质性；29% 的儿童至少有一项韦氏指数低于标准，特别是处理速度和工作记忆指数。31% 的儿童出现语言障碍，言语记忆 (28%)、视觉记忆 (23%)、执行功能 (21%) 和视觉注意力 (24%) 存在障碍。一半的儿童（50%）因学习困难需要康复治疗，26%的儿童有学业困难。家长问卷简要（执行功能的行为评定量表）显示，22% 的儿童在日常生活中存在显着的执行功能障碍。三分之一的患者（34%）需要对焦虑或社交障碍进行心理治疗，右侧囊肿患者和年龄较大的儿童比例更高。囊肿大小对神经心理影响很小。在所有 Wechsler 指数和 FSIQ 以及语言、言语记忆、注意力和视觉空间技能方面，凸性囊肿与非凸性囊肿的表现显着相关。与其他儿童相比，患有凸性囊肿的儿童在日常生活中的执行和行为困难以及更多的心理治疗明显更多。囊肿形状的影响与 Galassi 类型和囊肿侧无关。囊肿破裂或偶然发现囊肿的儿童通常具有良好的认知水平。四年后，没有初始疾病的儿童保持稳定，而那些没有接受手术的有困难的儿童需要更多的康复和学校适应。在所有 Wechsler 指数和 FSIQ 以及语言、言语记忆、注意力和视觉空间技能方面，凸性囊肿与非凸性囊肿的表现显着相关。与其他儿童相比，患有凸性囊肿的儿童在日常生活中的执行和行为困难以及更多的心理治疗明显更多。囊肿形状的影响与 Galassi 类型和囊肿侧无关。囊肿破裂或偶然发现囊肿的儿童通常具有良好的认知水平。四年后，没有初始疾病的儿童保持稳定，而那些没有接受手术的有困难的儿童需要更多的康复和学校适应。在所有 Wechsler 指数和 FSIQ 以及语言、言语记忆、注意力和视觉空间技能方面，凸性囊肿与非凸性囊肿的表现显着相关。与其他儿童相比，患有凸性囊肿的儿童在日常生活中的执行和行为困难以及更多的心理治疗明显更多。囊肿形状的影响与 Galassi 类型和囊肿侧无关。囊肿破裂或偶然发现囊肿的儿童通常具有良好的认知水平。四年后，没有初始疾病的儿童保持稳定，而那些没有接受手术的有困难的儿童需要更多的康复和学校适应。与其他儿童相比，患有凸性囊肿的儿童在日常生活中的执行和行为困难以及更多的心理治疗明显更多。囊肿形状的影响与 Galassi 类型和囊肿侧无关。囊肿破裂或偶然发现囊肿的儿童通常具有良好的认知水平。四年后，没有初始疾病的儿童保持稳定，而那些没有接受手术的有困难的儿童需要更多的康复和学校适应。与其他儿童相比，患有凸性囊肿的儿童在日常生活中的执行和行为困难以及更多的心理治疗明显更多。囊肿形状的影响与 Galassi 类型和囊肿侧无关。囊肿破裂或偶然发现囊肿的儿童通常具有良好的认知水平。四年后，没有初始疾病的儿童保持稳定，而那些没有接受手术的有困难的儿童需要更多的康复和学校适应。

这项大型队列研究揭示了 TAC 儿童的不同特征：在最初的评估中，50% 有神经心理困难，需要康复和/或心理治疗来治疗学习或行为困难，50% 没有困难，这可以解释关于这一点的争论病理。患有神经心理障碍的患者具有异质性，智力正常，但选择性认知和/或行为障碍可能对其生活质量产生长期影响，尤其是那些患有右侧囊肿的患者。对于偶然发现的囊肿，神经心理学评估并不总是必要的，但对于患有学术、学习或心理障碍的患者来说，早期评估是必不可少的。当评估显示可能与囊肿位置相关的选择性疾病时，可以考虑手术，