Cognitive Profiles of Children with Low Motor Performance: A Contribution to the Validation of the WPPSI-IV

Surgical treatment of interhemispheric arachnoid cysts

OBJECTIVE

In children, interhemispheric arachnoid cysts (IHACs) are rare lesions often associated with corpus callosum dysgenesis. It is still controversial about surgical treatments for IHACs. We aim to report our experience with pediatric IHAC patients and evaluate surgical courses and neurological developments.

METHODS

Pediatric IHACs treated between 2001 and 2021 were reviewed retrospectively. IHAC was observed until they represented rapid cyst enlargement or neurological symptoms. Cyst fenestration was done by microscope or endoscope, depending on the IHAC's location. Cyst size and corpus callosum dysgenesis were evaluated with neuroimaging. Neurological development was assessed from medical records at the last follow-up.

RESULTS

Fifteen children received cyst fenestration surgery (mean age 11.4 months). Eleven patients (73.3%) under observation showed rapid cyst enlargement in a short period (median 5 months). Cysto-ventriculostomy (CVS) and cysto-cisternostomy (CCS) regressed the cyst size significantly (p = 0.003). The median follow-up duration was 51 months (range 14-178 months). Corpus callosum dysgenesis was observed in eleven patients (73.3%, complete = 5, partial = 6). Among eight patients (53.3%) having developmental delay, five patients (33.3%) showed speech delay, including one patient with intractable seizures.

CONCLUSION

Pediatric IHACs frequently present within 1 year after birth, with rapid cyst enlargement. CVS and CCS were effective in regressing the cyst size. Corpus callosum dysgenesis accompanied by IHAC might have a risk of language achievement; however, development delay could rely on multifactorial features, such as epilepsy or other brain anomalies.

Perspective: Acknowledging complexity to advance the understanding of developmental coordination disorder

Developmental Coordination Disorder (DCD) is a heterogeneous neurodevelopmental disorder known for primary symptoms of motor learning and execution difficulties. Recent research has consistently suggested DCD symptoms span broadly beyond motor difficulties, yet a majority of research and practice approaches the investigation, diagnosis, and treatment of DCD with a reductionist framework. Therefore, this paper suggests the paradigm of complexity theory as a means for better conceptualization, assessment, and treatment of DCD. First, the perspective of complexity theory and its relevance to DCD is described. Then, examples from recent research which attempt to acknowledge and capture the complex nature of DCD are highlighted. Finally, suggestions for considering and measuring complexity of DCD in future research and practice are provided. Overall, the perspective of complexity can propel the research forward and improve the understanding of DCD relevant to assessment and treatment. The complexity paradigm is highly relevant to describing the evolving and multidimensional picture of DCD, understanding heterogeneous symptom profiles, making connections to interconnected secondary symptoms, and beyond.