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Maze learning in patients with intracranial arachnoid cysts

  • Experimental research - Functional
  • Published:
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Abstract

Background

The temporal lobe is of importance for visuospatial orientation. Intracranial arachnoid cysts have a predilection for the temporal fossa, and might therefore affect visuospatial orientation. The aim was to find out whether temporal cysts affect maze learning and if surgical cyst decompression improves maze performance.

Methods

Forty-five patients with a temporal arachnoid cyst and 17 control patients with cervical disc disease were tested in a labyrinth route in the hospital corridors the day before surgery and at least 3 months postoperatively.

Results

Thirty-five cyst patients (78 %) experienced postoperative improvement of their preoperative complaints. The cyst patients spent significantly longer time than the controls navigating through the maze in the preoperative test, 161 s and 127 s, respectively, but there was no difference in number of errors between the two groups. However, the cyst patients improved significantly in the postoperative test, both with regards to number of errors they made and time spent, contrary to the control patients, whose postoperative performance equalled that of the preoperative test. For the cyst patients, postoperative improvement in the labyrinth test correlated with the clinical outcome—but not the neuroradiological outcome—after the operation.

Conclusions

Thus, temporal arachnoid cysts may affect visuospatial orientation and learning in a reversible manner.

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Acknowledgments

The participation of Dr. Einar Vik-Mo in the early phases of the study is acknowledged.

Funding

This work was partly supported by a research grant to C. A. Helland from the Norwegian Research Council Medical Research Division and a PhD research grant from Health Region West, Norway. The other authors received no funding.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgical Sciences, University of Bergen, Bergen, Norway

    Elisabeth Isaksen, Therese Hamre Leet, Christian A. Helland & Knut Wester

  2. Department of Neurosurgery, Haukeland University Hospital, 5021, Bergen, Norway

    Christian A. Helland & Knut Wester

Authors
  1. Elisabeth Isaksen
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  2. Therese Hamre Leet
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  3. Christian A. Helland
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  4. Knut Wester
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Corresponding author

Correspondence to Knut Wester.

Additional information

Comment

The surgical indication in presence of temporal arachnoid cysts requires a meticulous inquiry of the signs and symptoms of patients, and the analysis of the perioperative surgical risks. In absence of mass effect or symptoms, there is generally a conservative tendency, regardless of their size and location.

In this well-written study, the authors analysed prospectively 45 patients with symptomatic arachnoidal temporal cysts (37.7 % of Type I, 49 % of Type II, 13 % of Type III). Seventeen patients with cervical disc disease were enrolled as control. As declared by the authors, a matching for intellectual or educational status was not possible, so that the control group remains suboptimal. Nevertheless, this study demonstrated a significant amelioration of visuo-spatial orientation and a strong correlation between clinical outcome and postoperative improvement in the labyrinth test after microsurgical fenestration of temporal arachnoid cysts. Unfortunately, the authors provide CT scans with different angling, and so they are not really comparable.

Even with certain limitations, this study is well conducted and corroborates the effectiveness of the microsurgical treatment in presence of temporal arachnoid cysts even for spatial memory and visuospatial orientation skills.

Alex Alfieri,

Wittenberg, Germany

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Isaksen, E., Leet, T.H., Helland, C.A. et al. Maze learning in patients with intracranial arachnoid cysts. Acta Neurochir 155, 841–848 (2013). https://doi.org/10.1007/s00701-013-1641-0

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  • DOI: https://doi.org/10.1007/s00701-013-1641-0

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