ABSTRACT
To summarize the clinical characteristics of intracranial arachnoid cysts (IACs) in pediatric cases. A retrospective analysis was carried out on clinical characteristics of IACs in 488 pediatric cases who were treated at our hospital from January 2003 to September 2013. There were 342 males and 146 females (male-to-female ratio, 2.34:1), aged 5.61±3.25 years on average. 221 cases (45.29%) were diagnosed accidentally, 267 cases had clinical complaints (54.71%), among which relationships between clinical complaints and IACs were identified in 123 (46.07%). Simple IACs occurred in 364 cases (4.59%), and concurrent congenital abnormalities occurred in 124 cases (4.59%). In terms of location, 355 had IACs in middle cranial fossa (72.75%), 82 cases in posterior cranial fossa (16.80%), 20 cases in anterior cranial fossa (4.10%), 12 cases in dorsolateral surface (2.46%), 7 cases in suprasellar cistern (1.43%), 5 cases in cerebral ventricle (1.02%), 5 cases in quadrigeminal cistern (1.02%), and 2 cases in interhemispheric region (0.41%). There were 449 cases with single IAC (92.01%) and 39 cases with multiple IACs (7.99%). On MRI, the cysts produced tension in 127 cases (26.02%), but not in the remaining 361 cases (73.98%). Surgery was performed on 76 of 488 cases (15.57%), while conservative observation was accepted in 412 cases (84.43%). For the former, the symptoms and the cyst volume were improved to varying extent; for the latter, the follow-up lasting for 3-72 months (average 32.43±8.92 months) showed that the cyst volume remained stable in 407 cases (98.78%), enlarged with aggravated symptoms in 3 cases (0.73%), and shrank in 2 cases (0.49%). Clinical complaints of IACs varied in pediatric cases, and the relationships between clinical complaints and IACs were established only partially. Some pediatric cases were combined with other congenital abnormalities. The cyst volume largely remained stable during the disease course, and surgery was required for only a few IACs.
ABSTRACT
The aim of this systematic review was to examine the relationship between pre-operative peritumoral edema and survival in patients with glioblastoma multiforme (GBM). We searched for studies involving patients with GBM who underwent pre-operative imaging (magnetic resonance imaging and/or computed tomography) in which the peritumoral edema was assessed as a prognostic factor for survival. 7 retrospective studies met the eligibility criteria and were included in the study. 2 studies found that pre-operative peritumoral edema was an independent prognostic factor for decreased survival. 1 study found that survival was dependent on the severity of the peritumoral edema (minimal and severe: increased survival; moderate: decreased survival). 2 studies found that pre-operative peritumoral edema was a predictor of decreased survival based on univariate but not multivariate analysis. 1 study found that there was no relationship between pre-operative peritumoral edema and survival, while the remaining study found that patients with peritumoral edema had decreased survival compared with patients without peritumoral edema. There was considerable heterogeneity between the studies regarding the patient characteristics. The results of our systematic review are inconclusive; the available evidence does not definitely support or rule out an association between pre-operative peritumoral edema and survival. Hence, further, well-designed, prospective studies are clearly needed.
