{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:59:49Z","timestamp":1787320789223,"version":"build-2736575974"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Prenatally diagnosed complex arachnoid cysts are very rare. While the true prenatal incidence is still unknown, they account for approximately 1% of intracranial masses in newborns. They rarely exhibit rapid growth or cause obstructive hydrocephalus, but if they increase to such a dimension during pregnancy, the ideal management is not well established. We present our detailed perinatal experience, covering prenatal diagnosis, a compassionate delivery process, and neonatal stabilization. Finally, a thorough postnatal neurosurgical intervention was performed. Initially, our focus was on the gradual reduction of cyst size as a primary effort, followed by subsequent definitive surgical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case series shows the treatment course of three fetuses with antenatally diagnosed large arachnoid cysts. We present pre- and postnatal management and imaging, as well as the surgical treatment plan and the available clinical course during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two girls and one boy were included in the current review. All three cases presented with prenatally diagnosed complex arachnoid cysts that increased in size during pregnancy. The mean gestational age at delivery was 35 weeks (range 32 to 37 weeks), and all patients were delivered by a caesarian section. Increasing head circumference and compression of brain structures were indications for delivery, as they are associated with a high risk of excess intracranial pressures and CSF diapedesis, as well as traumatic delivery and maternal complications. All cysts were supratentorial in location; one expanded into the posterior fossa, and one was a multicompartment cyst. All children underwent an initial surgical procedure within the first days of life. To relieve cyst pressure and achieve a reduction in head circumference, an ultrasound-guided or endoscopic-assisted internal shunt with drainage of the cyst to the ventricles or subdural\/subarachnoid space was inserted. Definite surgical therapy consisted of cyst marsupialization and\/or cysto-peritoneal shunt implantation. All children survived without severe neurodevelopmental impairments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With the cases presented, we demonstrate that the slow reduction of immense cyst size as an initial procedure until optimal requirements for final surgical treatment were achieved has proven to be optimal for neurological outcome. Special emphasis has to be taken on the delicate nature of premature newborn babies, and surgical steps have to be thoroughly considered within the interdisciplinary team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-024-06385-w","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T01:01:17Z","timestamp":1712797277000},"page":"1997-2007","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Staged neurosurgical approach for giant and progressive neonatal arachnoid cysts: a case series and review of the literature"],"prefix":"10.1007","volume":"40","author":[{"given":"Aurelia","family":"Peraud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Schuler-Ortoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schaal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Reister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Ehrhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Friebe-Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"issue":"2","key":"6385_CR1","first-page":"28","volume":"3","author":"EM Pappalardo","year":"2009","unstructured":"Pappalardo EM, Militello M, Rapisarda G, Imbruglia L, Recupero S, Ermito S et al (2009) Fetal intracranial cysts: prenatal diagnosis and outcome. J Prenat Med 3(2):28\u201330","journal-title":"J Prenat Med"},{"key":"6385_CR2","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.ejrad.2019.02.027","volume":"113","author":"O Yahal","year":"2019","unstructured":"Yahal O, Katorza E, Zvi E, Berkenstadt M, Hoffman C, Achiron R et al (2019) Prenatal diagnosis of arachnoid cysts: MRI features and neurodevelopmental outcome. Eur J Radiol 113:232\u2013237. https:\/\/doi.org\/10.1016\/j.ejrad.2019.02.027","journal-title":"Eur J Radiol"},{"key":"6385_CR3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/978-1-4614-0653-2_3","volume":"724","author":"T Westermaier","year":"2012","unstructured":"Westermaier T, Schweitzer T, Ernestus RI (2012) Arachnoid cysts. Adv Exp Med Biol 724:37\u201350. https:\/\/doi.org\/10.1007\/978-1-4614-0653-2_3","journal-title":"Adv Exp Med Biol"},{"issue":"6","key":"6385_CR4","doi-asserted-by":"publisher","first-page":"578","DOI":"10.3171\/2010.2.PEDS09464","volume":"5","author":"WN Al-Holou","year":"2010","unstructured":"Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO (2010) Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 5(6):578\u2013585. https:\/\/doi.org\/10.3171\/2010.2.PEDS09464","journal-title":"J Neurosurg Pediatr"},{"key":"6385_CR5","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-022-01809-0","author":"ST J\u00fcnger","year":"2022","unstructured":"J\u00fcnger ST, Knerlich-Lukoschus F, R\u00f6hrig A, Al Hourani J, Kunze S, Eberle J et al (2022) Clinical variety and prognosis of intracranial arachnoid cysts in children. Neurosurg Rev. https:\/\/doi.org\/10.1007\/s10143-022-01809-0","journal-title":"Neurosurg Rev"},{"issue":"5","key":"6385_CR6","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/BF00300797","volume":"8","author":"RW Oberbauer","year":"1992","unstructured":"Oberbauer RW, Haase J, Pucher R (1992) Arachnoid cysts in children: a European co-operative study. Childs Nerv Syst 8(5):281\u2013286. https:\/\/doi.org\/10.1007\/BF00300797","journal-title":"Childs Nerv Syst"},{"key":"6385_CR7","doi-asserted-by":"publisher","first-page":"621","DOI":"10.25259\/SNI_946_2021","volume":"12","author":"J Carbone","year":"2021","unstructured":"Carbone J, Sadasivan AP (2021) Intracranial arachnoid cysts: review of natural history and proposed treatment algorithm. Surg Neurol Int 12:621. https:\/\/doi.org\/10.25259\/SNI_946_2021","journal-title":"Surg Neurol Int"},{"key":"6385_CR8","doi-asserted-by":"publisher","first-page":"5493769","DOI":"10.1155\/2016\/5493769","volume":"2016","author":"SV McLaurin-Jiang","year":"2016","unstructured":"McLaurin-Jiang SV, Wood JK, Crudo DF (2016) Septooptic dysplasia with an associated arachnoid cyst. Case Rep Pediatr 2016:5493769. https:\/\/doi.org\/10.1155\/2016\/5493769","journal-title":"Case Rep Pediatr"},{"key":"6385_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuchi.2022.07.004","author":"N Silva Baticam","year":"2022","unstructured":"Silva Baticam N, Aloy E, Rolland A, Fuchs F, Roujeau T (2022) Prenatally symptomatic suprasellar arachnoid cyst: when to treat?\u00a0A case-base update. Neurochirurgie. https:\/\/doi.org\/10.1016\/j.neuchi.2022.07.004","journal-title":"Neurochirurgie"},{"issue":"1","key":"6385_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000445718","volume":"40","author":"A Youssef","year":"2016","unstructured":"Youssef A, D\u2019Antonio F, Khalil A, Papageorghiou AT, Ciardulli A, Lanzone A et al (2016) Outcome of fetuses with supratentorial extra-axial intracranial cysts: a systematic review. Fetal Diagn Ther 40(1):1\u201312. https:\/\/doi.org\/10.1159\/000445718","journal-title":"Fetal Diagn Ther"},{"issue":"2","key":"6385_CR11","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.ejpn.2014.12.008","volume":"19","author":"B De Keersmaecker","year":"2015","unstructured":"De Keersmaecker B, Ramaekers P, Claus F, Witters I, Ortibus E, Naulaers G et al (2015) Outcome of 12 antenatally diagnosed fetal arachnoid cysts: case series and review of the literature. Eur J Paediatr Neurol 19(2):114\u2013121. https:\/\/doi.org\/10.1016\/j.ejpn.2014.12.008","journal-title":"Eur J Paediatr Neurol"},{"issue":"24","key":"6385_CR12","doi-asserted-by":"publisher","first-page":"4728","DOI":"10.1080\/14767058.2020.1863361","volume":"35","author":"TB Grossman","year":"2022","unstructured":"Grossman TB, Uribe-Cardenas R, Radwanski RE, Souweidane MM, Hoffman CE (2022) Arachnoid cysts: using prenatal imaging and need for pediatric neurosurgical intervention to better understand their natural history and prognosis. J Matern Fetal Neonatal Med 35(24):4728\u20134733. https:\/\/doi.org\/10.1080\/14767058.2020.1863361","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"6","key":"6385_CR13","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1002\/uog.11071","volume":"39","author":"G Gandolfi Colleoni","year":"2012","unstructured":"Gandolfi Colleoni G, Contro E, Carletti A, Ghi T, Campobasso G, Rembouskos G et al (2012) Prenatal diagnosis and outcome of fetal posterior fossa fluid collections. Ultrasound Obstet Gynecol 39(6):625\u2013631. https:\/\/doi.org\/10.1002\/uog.11071","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"10\u201311","key":"6385_CR14","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s003810000316","volume":"16","author":"A Pierre-Kahn","year":"2000","unstructured":"Pierre-Kahn A, Hanlo P, Sonigo P, Parisot D, McConnell RS (2000) The contribution of prenatal diagnosis to the understanding of malformative intracranial cysts: state of the art. Childs Nerv Syst 16(10\u201311):619\u2013626. https:\/\/doi.org\/10.1007\/s003810000316","journal-title":"Childs Nerv Syst"},{"issue":"1","key":"6385_CR15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/01443610601062762","volume":"27","author":"CK Ruprai","year":"2007","unstructured":"Ruprai CK, Pring DW, Vipond A, Duffey P (2007) Pregnancy complicated by a large intracranial arachnoid cyst: multidisciplinary approach to safe delivery. J Obstet Gynaecol 27(1):83\u201385. https:\/\/doi.org\/10.1080\/01443610601062762","journal-title":"J Obstet Gynaecol"},{"key":"6385_CR16","doi-asserted-by":"crossref","unstructured":"Chalouhi GE, Marangoni M, Zerah M, Ville Y (2012) Intrauterine treatment of a suprasellar inter-hemispheric arachnoid cyst by feto-cisternoscopy. Poster Abstract P09.24. 22nd World Congress on Ultrasound in Obstetrics and Gynecology. Ultrasound Obstet Gynecol 171\u2013310","DOI":"10.1002\/uog.11900"},{"issue":"3","key":"6385_CR17","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1227\/NEU.0000000000001049","volume":"78","author":"A Andr\u00e9","year":"2016","unstructured":"Andr\u00e9 A, Z\u00e9rah M, Roujeau T, Brunelle F, Blauwblomme T, Puget S et al (2016) Suprasellar arachnoid cysts: toward a new simple classification based on prognosis and treatment modality. Neurosurg 78(3):370\u20139. Discussion 9\u201380.\u00a0https:\/\/doi.org\/10.1227\/NEU.0000000000001049","journal-title":"Neurosurg"},{"issue":"5","key":"6385_CR18","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/0090-3019(82)90315-9","volume":"17","author":"E Galassi","year":"1982","unstructured":"Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, Frank G (1982) CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol 17(5):363\u2013369. https:\/\/doi.org\/10.1016\/0090-3019(82)90315-9","journal-title":"Surg Neurol"},{"key":"6385_CR19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4103\/sni.sni_245_17","volume":"9","author":"N Takeshige","year":"2018","unstructured":"Takeshige N, Eto T, Nakashima S, Sakata K, Uchikado H, Abe T et al (2018) Rare case of a rapidly enlarging symptomatic arachnoid cyst of the posterior fossa in an infant: a case report and review of the literature. Surg Neurol Int 9:57. https:\/\/doi.org\/10.4103\/sni.sni_245_17","journal-title":"Surg Neurol Int"},{"issue":"5","key":"6385_CR20","doi-asserted-by":"publisher","first-page":"544","DOI":"10.3171\/2021.5.PEDS21119","volume":"28","author":"J Soleman","year":"2021","unstructured":"Soleman J, Kozyrev DA, Constantini S, Roth J (2021) Surgical treatment and outcome of posterior fossa arachnoid cysts in infants. J Neurosurg Pediatr 28(5):544\u2013552. https:\/\/doi.org\/10.3171\/2021.5.PEDS21119","journal-title":"J Neurosurg Pediatr"},{"issue":"1","key":"6385_CR21","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1080\/02688699944122","volume":"13","author":"P Erdin\u00e7ler","year":"1999","unstructured":"Erdin\u00e7ler P, Kaynar MY, Bozkus H, Ciplak N (1999) Posterior fossa arachnoid cysts. Br J Neurosurg 13(1):10\u201317. https:\/\/doi.org\/10.1080\/02688699944122","journal-title":"Br J Neurosurg"},{"issue":"11","key":"6385_CR22","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1002\/pd.2346","volume":"29","author":"K Haino","year":"2009","unstructured":"Haino K, Serikawa T, Kikuchi A, Takakuwa K, Tanaka K (2009) Prenatal diagnosis of fetal arachnoid cyst of the quadrigeminal cistern in ultrasonography and MRI. Prenat Diagn 29(11):1078\u20131080. https:\/\/doi.org\/10.1002\/pd.2346","journal-title":"Prenat Diagn"},{"key":"6385_CR23","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-022-05457-z","author":"M Endo","year":"2022","unstructured":"Endo M, Usami K, Masaaki N, Ogiwara H (2022) A neonatal purely prepontine arachnoid cyst: a case report and review of the literature. Childs Nerv Syst. https:\/\/doi.org\/10.1007\/s00381-022-05457-z","journal-title":"Childs Nerv Syst"},{"issue":"10","key":"6385_CR24","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.7863\/jum.2010.29.10.1487","volume":"29","author":"A Gedikbasi","year":"2010","unstructured":"Gedikbasi A, Palabiyik F, Oztarhan A, Yildirim G, Eren C, Ozyurt SS et al (2010) Prenatal diagnosis of a suprasellar arachnoid cyst with 2- and 3-dimensional sonography and fetal magnetic resonance imaging: difficulties in management and review of the literature. J Ultrasound Med 29(10):1487\u20131493. https:\/\/doi.org\/10.7863\/jum.2010.29.10.1487","journal-title":"J Ultrasound Med"},{"issue":"2 Suppl","key":"6385_CR25","doi-asserted-by":"publisher","first-page":"S20.e1","DOI":"10.1016\/j.wneu.2012.02.010","volume":"79","author":"P Spennato","year":"2013","unstructured":"Spennato P, Ruggiero C, Aliberti F, Buonocore MC, Trischitta V, Cinalli G (2013) Interhemispheric and quadrigeminal cysts. World Neurosurg 79(2 Suppl):S20.e1-7. https:\/\/doi.org\/10.1016\/j.wneu.2012.02.010","journal-title":"World Neurosurg"},{"issue":"4","key":"6385_CR26","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1159\/000165511","volume":"24","author":"F Fuchs","year":"2008","unstructured":"Fuchs F, Moutard ML, Blin G, Sonigo P, Mandelbrot L (2008) Prenatal and postnatal follow-up of a fetal interhemispheric arachnoid cyst with partial corpus callosum agenesis, asymmetric ventriculomegaly and localized polymicrogyria. Case report Fetal Diagn Ther 24(4):385\u2013388. https:\/\/doi.org\/10.1159\/000165511","journal-title":"Case report Fetal Diagn Ther"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-024-06385-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-024-06385-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-024-06385-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:04:50Z","timestamp":1718409890000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-024-06385-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,11]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["6385"],"URL":"https:\/\/doi.org\/10.1007\/s00381-024-06385-w","relation":{},"ISSN":["0256-7040","1433-0350"],"issn-type":[{"value":"0256-7040","type":"print"},{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,11]]},"assertion":[{"value":"30 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent to participate and consent for publication were obtained from the patients\u2019 legal representatives included in this report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and consent for publication"}},{"value":"The authors declare that they have no conflicts of interest to declare that is relevant to the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}