-
Cirugia Y Cirujanos 2010Arachnoid cysts (ACs) contain a liquid similar to cerebrospinal fluid. Some communicate with the subarachnoid space and others do not. These cysts are reported to... (Review)
Review
BACKGROUND
Arachnoid cysts (ACs) contain a liquid similar to cerebrospinal fluid. Some communicate with the subarachnoid space and others do not. These cysts are reported to account for at least 1% of all intracranial mass lesions. Most patients present during the first two decades of life; however, presentation during adulthood is not uncommon.
DISCUSSION
A literature review to identify studies relating to pathogenesis, epidemiology, genetics, presentation, radiology and treatment of ACs was conducted and indicated that symptoms depend on size and location. When ACs are symptomatic, they must be treated surgically. Surgical treatment of ACs can be accomplished by cystoperitoneal shunting or fenestration of the cyst either by craniotomy or endoscopic techniques.
CONCLUSIONS
Currently, appropriate treatment is still controversial regarding which is the best technique. Expectative treatment should be considered in lower volume cysts and, even more, in asymptomatic patients diagnosed by other studies.
Topics: Arachnoid Cysts; Humans
PubMed: 21214995
DOI: No ID Found -
Child's Nervous System : ChNS :... Jul 2020Quadrigeminal arachnoid cyst (QAC) associated with encephalocele is rare; and while some treatments have been developed in recent years, no definite therapeutic approach... (Review)
Review
INTRODUCTION
Quadrigeminal arachnoid cyst (QAC) associated with encephalocele is rare; and while some treatments have been developed in recent years, no definite therapeutic approach for QAC has been established. Endoscopic treatment for arachnoid cyst is gaining popularity because it is relatively less invasive to the normal brain tissues.
CASE PRESENTATION
The patient, a 4-year-old girl, presented with QAC associated with congenital occipital encephalocele. At the age of 1 month, repair of the perinatal encephalocele had been performed at another institute. An asymptomatic arachnoid cyst remained in the posterior fossa, which was closely monitored with follow up. At age 4 years, the patient started to complain of headache, which gradually increased in both strength and frequency. Magnetic resonance imaging (MRI) revealed cerebellar compression due to cyst enlargement. We performed neuroendoscopic cyst fenestration with an occipital bone approach. Post-operative MRI showed reduced size of the cyst, and the headache dramatically improved and resolved.
DISCUSSION
The standard treatment of QAC is still controversial; however, our successful use of endoscopic fenestration toward the third ventricle indicates its efficacy and safety. QACs have been classified into 3 types based on their expansion mechanisms; our case might suggest another possible mechanism of QAC development.
CONCLUSION
In our case, endoscopic cyst fenestration was successful for QAC with perinatal encephalocele. However, long-term follow-up and analysis of similar cases are needed to determine its effectiveness.
Topics: Arachnoid Cysts; Child, Preschool; Encephalocele; Female; Humans; Magnetic Resonance Imaging; Neuroendoscopy; Third Ventricle
PubMed: 32328704
DOI: 10.1007/s00381-020-04626-2 -
World Neurosurgery Jun 2020Symptomatic intramedullary arachnoid cysts are rarely observed lesions, particularly in the pediatric age group. Treatment includes cyst fenestration or resection of the... (Review)
Review
BACKGROUND
Symptomatic intramedullary arachnoid cysts are rarely observed lesions, particularly in the pediatric age group. Treatment includes cyst fenestration or resection of the cyst wall, and recurrence after surgery has never been reported. We report a rare case of a spinal intramedullary arachnoid cyst, which recurred after cyst fenestration and required reoperation after a certain period.
CASE DESCRIPTION
A 4-year-old boy presented to our hospital with tetraparesis and bladder and rectum disorder. A cystic intramedullary lesion in the cervical spinal cord was detected in preoperative imaging. An emergency fenestration of cyst was performed, and his symptoms were resolved immediately. One month after the operation, the symptoms and cyst recurred. The symptoms improved in the natural course without reoperation. However, the cyst increased in size and the symptoms recurred after 27 months from the first relapse and the cyst was removed urgently. The diagnosis was an arachnoid cyst. After the reoperation, the cyst has disappeared and not recurred.
CONCLUSIONS
To the best of our knowledge, this is the first report of recurrence of an intramedullary arachnoid cyst. This case indicates the importance of considering the resection of cyst wall as possible because of the probability of cyst recurrence after fenestration, while careful observation is the option in the short term, especially for children or high-risk cases.
Topics: Arachnoid Cysts; Cervical Cord; Child, Preschool; Humans; Male; Recurrence; Reoperation; Spinal Cord Diseases
PubMed: 32142944
DOI: 10.1016/j.wneu.2020.02.106 -
Journal of Neurosurgery Oct 1996
Topics: Adult; Arachnoid Cysts; Female; Humans; Intracranial Aneurysm; Subarachnoid Hemorrhage
PubMed: 8814187
DOI: 10.3171/jns.1996.85.4.0734a -
Child's Nervous System : ChNS :... Sep 2016Kallmann syndrome (KS) is defined by the association of hypogonadotropic hypogonadism and anosmia. It is characterized by a significant clinical and genetic... (Review)
Review
BACKGROUND
Kallmann syndrome (KS) is defined by the association of hypogonadotropic hypogonadism and anosmia. It is characterized by a significant clinical and genetic heterogeneity; actually, it may present several non-reproductive non-olfactory anomalies, and all the ways of genetic transmission can be involved in the inheritance of the disease. Although six pathogenesis-related genes have been identified so far, KS remains sporadic in 70 % of the cases, and the genetic diagnosis is not available for all of them. The purpose of this paper is to present a further disease that can enrich the wide spectrum of KS variability, that is cerebral arachnoid cyst.
CASE DESCRIPTION
This 11-year-old boy presented with the typical characteristics of KS together with those related to a sylvian arachnoid cyst. He was admitted because of worsening headache. At the admission, the physical examination revealed eunuchoid aspect, micropenis, previous cryptorchidism, and anosmia. MRI pointed out a large, left sylvian arachnoid cyst, agenesia of the olfactory bulbs/tracts complex, and hypoplasia of the left olfactory sulcus. The child was operated on by endoscopic fenestration of the cyst, followed by transient external drainage for subdural hygroma and microscopic fenestration for recurrence of the cyst. His statural growth is normal but the sexual development still delayed in spite of hormone replacement therapy.
CONCLUSION
According to the present and the other four cases in the literature, arachnoid cyst should be included among the anomalies possibly accompanying KS date although this association seems to be occasional as far as embryogenesis and physiopathology are concerned.
Topics: Arachnoid Cysts; Child; Hormone Replacement Therapy; Humans; Kallmann Syndrome; Magnetic Resonance Imaging; Male
PubMed: 27379494
DOI: 10.1007/s00381-016-3154-7 -
Child's Nervous System : ChNS :... May 2020Intracranial interdural cyst is a rare lesion. The exact pathophysiology of these cysts remains unknown.
BACKGROUND
Intracranial interdural cyst is a rare lesion. The exact pathophysiology of these cysts remains unknown.
CLINICAL PRESENTATION
We report an infant with interdural cyst of the tentorium cerebelli. Although the cyst mimicked an arachnoid cyst on pre- and postnatal magnetic resonance images, lateral suboccipital craniotomy revealed the cyst within the tentorium. Fenestration on the infratentorial side was performed with successful results. Histologically, the inner surface of the cyst was lined with arachnoid cells.
CONCLUSION
We report detailed neuroradiological, intraoperative, and histological findings, and discuss the pathophysiology of the cyst in this case.
Topics: Arachnoid Cysts; Craniotomy; Dura Mater; Humans; Infant; Magnetic Resonance Imaging
PubMed: 31655875
DOI: 10.1007/s00381-019-04404-9 -
The New England Journal of Medicine Jun 2017
Topics: Adult; Arachnoid Cysts; Brain; Headache; Humans; Magnetic Resonance Imaging; Male; Seizures
PubMed: 28591531
DOI: 10.1056/NEJMicm1610483 -
Asian Journal of Surgery Jun 2023
Review
Topics: Humans; Spinal Cord Diseases; Arachnoid Cysts; Magnetic Resonance Imaging
PubMed: 36641278
DOI: 10.1016/j.asjsur.2022.12.110 -
Child's Nervous System : ChNS :... Sep 2022Purely prepontine arachnoid cysts not extending into the suprasellar region in neonates are rare. Herein, we report a purely prepontine arachnoid cyst in a neonate which... (Review)
Review
Purely prepontine arachnoid cysts not extending into the suprasellar region in neonates are rare. Herein, we report a purely prepontine arachnoid cyst in a neonate which caused central apnea and was successfully treated with microscopic cyst fenestration and C1 laminectomy.
Topics: Arachnoid Cysts; Humans; Infant, Newborn; Laminectomy; Skull; Sleep Apnea, Central
PubMed: 35532779
DOI: 10.1007/s00381-022-05457-z -
Journal of Clinical Neuroscience :... Sep 2011Preoperative, operative and postoperative radiological examinations and operative notes of 31 patients with spinal arachnoid cyst operated on during 2002-2009 at the...
Preoperative, operative and postoperative radiological examinations and operative notes of 31 patients with spinal arachnoid cyst operated on during 2002-2009 at the Institute of Medical Sciences, Banaras Hindu University, were evaluated. Sixteen patients were male and 15 were female. All patients were managed surgically: extradural arachnoid cysts were managed by excision and intradural arachnoid cysts were managed by marsupialization. There was no recurrence in the 4 years of follow up.
Topics: Adult; Arachnoid Cysts; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Postoperative Complications; Retrospective Studies; Spinal Cord Diseases
PubMed: 21724400
DOI: 10.1016/j.jocn.2010.11.023