Factors that Influence Subdural Hemorrhage Secondary to Intracranial Arachnoid Cysts in Children

OBJECTIVE: This study aimed to investigate factors that influence subdural haemorrhage (SDH) secondary to intracranial arachnoid cysts (IACs) in children.METHODS: Data of children with unruptured IACs (IAC group) and those with SDH secondary to IACs (IAC-SDH group) were analyzed. Nine factors, sex, age, birth type (vaginal or caesarean), symptoms, side (left, right, or midline), location (temporal or nontemporal), image type (I, II, or III), volume, and maximal diameter, were selected. IACs were classified as types I, II, and III according to their morphological changes observed on computed tomography images.RESULTS: There were 117 boys (74.5%) and 40 girls (25.5%); 144 (91.7%) patients comprised the IAC group and 13 (8.3%) comprised the IAC-SDH group. There were 85 (53.8%) IACs on the left side, 53 (33.5%) on the right side, 20 (12.7%) in the midline region, and 91 (58.0%) in the temporal region. The univariate analysis showed significant differ-ences in age, birth type, symptoms, cyst location, cyst volume, and cyst maximal diameter (P< 0.05) between the 2 groups. Logistic regression using the synthetic minority oversampling technique model showed that image type III and birth type were independent factors that influenced SDH secondary to IACs (b0 = 4.143; b for image type = L3.979; b for birth type = L2.542) and that the representative area under the receiver-operating charac-teristic curve value was 0.948 (95% confidence interval, 0.898e0.997).CONCLUSIONS: IACs are more common in boys than in girls. They can be divided into 3 groups according to their morphological changes on computed tomography images. Image type III and caesarean delivery were independent factors that influenced SDH secondary to IACs.

Automated summary

This study investigated factors that affect SDH secondary to IACs in children. It was found that IACs are more common in boys than girls, and can be classified into three groups based on morphological changes on CT images. Image type III and caesarean delivery were identified as independent factors that influence SDH secondary to IACs.