Introduction: Currently, there is no consensus recommendation regarding the safety of sports participation for pediatric patients with arachnoid cysts (AC). We aimed to prospectively survey AC patients to define the risk of sports-associated neurologic injury in untreated and treated patients.
Methods: A prospectively administered survey was administered to all patients diagnosed with an AC who presented to a single pediatric neurosurgery clinic between December 2010 and December 2021. Data were recorded on demographic information, imaging characteristics, treatment, sports participation, and presence of sports-related neurologic injury. Type and timing of surgery for the AC was noted if performed. Patients with incomplete survey data were called.
Results: Of the 305 patients with completed surveys, 189 patients participated in sports. Sports participants were more likely to be older at survey administration (p < 0.001) and AC diagnosis (p < 0.001). There was no significant difference in cyst location or Galassi score between patients who did and did not participate in sports, participated in contact vs non-contact sports, and those who did and did not experience a concussion. A cumulative total of 2,700.5 seasons of sports were played (2,499.7 in untreated and 200.8 in treated patients). There were 44 sports-related concussions among 34 patients; 43 in untreated patients and 1 in a treated patient. For all participants, the concussion rate was 16.3 per 1,000 seasons all sports and 14.8 per 1,000 seasons of contact sports. The concussion rate after AC treatment was 4.9 per 1,000 seasons for all sports. Two patients experienced sports-related AC rupture, neither of which required surgery or resulted in lasting neurologic issues.
Conclusion : There were two reports of sports-related AC rupture during the 10-year study period; neither required surgery. The concussion rate in AC patients in both treated and untreated populations were low and therefore sports participation in this population should not be counseled against.
