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Pediatric Neurosurgery 2021Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time.
INTRODUCTION
Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time.
CASE REPORT
We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development.
DISCUSSION/CONCLUSION
Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.
Topics: Adult; Arachnoid Cysts; Child; Female; Humans; Infant; Magnetic Resonance Imaging; Meningocele; Meningomyelocele; Tomography, X-Ray Computed
PubMed: 33550309
DOI: 10.1159/000512862 -
Neurosurgery Jan 2011Arachnoid cysts have not been reported to be located within the brain parenchyma. We present a case of an arachnoid cyst that was contained entirely within the right...
BACKGROUND AND IMPORTANCE
Arachnoid cysts have not been reported to be located within the brain parenchyma. We present a case of an arachnoid cyst that was contained entirely within the right frontal lobe devoid of communication with the subarachnoid space and ventricle.
CLINICAL PRESENTATION
A 65-year-old woman presented with a 1-year history of progressive headache and nausea. Computed tomographic and magnetic resonance imagining scans showed a well-defined, nonenhancing mass measuring 5 × 5 × 3.5 cm in the right frontal lobe. The mass appeared to be contained entirely within the brain parenchyma. The patient underwent a right frontal craniotomy, at which time the cystic mass was identified in the brain parenchyma without any communication with the arachnoid space. The cyst contained a clear fluid, and its wall was excised. The fluid contents demonstrated a composition similar to that of normal cerebrospinal fluid. Histological and immunohistochemical examinations of the cyst wall were compatible with the diagnosis of an arachnoid cyst. Postoperatively, the symptoms of the patient resolved, and no recurrence was observed up to 6 months after removal.
CONCLUSION
The present case showed an intraparenchymal arachnoid cyst arising in the frontal lobe. Although the etiology is not known, an arachnoid cyst should be included in the differential diagnosis of primary intracerebral cysts.
Topics: Aged; Arachnoid Cysts; Craniotomy; Female; Frontal Lobe; Headache; Humans; Magnetic Resonance Imaging; Nausea; Tomography, X-Ray Computed
PubMed: 21150741
DOI: 10.1227/NEU.0b013e3181ff355c -
European Spine Journal : Official... Oct 2006The pathogenesis, etiology, and treatment of the spinal arachnoid cyst have not been well established because of its rarity. A 57-year-old male was presented with... (Review)
Review
The pathogenesis, etiology, and treatment of the spinal arachnoid cyst have not been well established because of its rarity. A 57-year-old male was presented with spastic quadriparesis predominantly on the left side. His radiological examination showed widening of the cervical spinal canal and left neural foramina due to a cerebrospinal fluid-filled extradural cyst that extended from C2 to T2 level. The cyst was located left anterolaterally, compressing the spinal cord. Through a C4-T2 laminotomy, the cyst was excised totally and the dural defect was repaired. Several features of the reported case, such as cyst size, location, and clinical features make it extremely unusual. The case is discussed in light of the relevant literature.
Topics: Arachnoid Cysts; Cervical Vertebrae; Dura Mater; Humans; Male; Middle Aged; Neurosurgical Procedures; Quadriplegia; Spinal Cord Compression; Spinal Cord Diseases; Thoracic Vertebrae
PubMed: 16474947
DOI: 10.1007/s00586-005-0041-4 -
Postgraduate Medical Journal Oct 1992A patient with an uncommonly situated congenital intradural arachnoid cyst is reported. The cyst extended from the cervical spinal canal into the posterior cranial fossa...
A patient with an uncommonly situated congenital intradural arachnoid cyst is reported. The cyst extended from the cervical spinal canal into the posterior cranial fossa and was posterolateral to the spinal cord. The patient's initial complaint was urinary hesitancy. The location of the cyst is unique and the presenting complaint rare.
Topics: Adult; Arachnoid Cysts; Humans; Male; Spinal Diseases; Tomography, X-Ray Computed; Urination Disorders
PubMed: 1461857
DOI: 10.1136/pgmj.68.804.829 -
World Neurosurgery Jul 2018Cerebral arachnoid cysts that eroded the skull base and extended into the paranasal sinus are very rare with only a few cases reported.
BACKGROUND
Cerebral arachnoid cysts that eroded the skull base and extended into the paranasal sinus are very rare with only a few cases reported.
CASE DESCRIPTION
A 71-year-old woman with history of headache for 4 years was evaluated because of an enlarging right temporal cystic lesion with evidence of resorption of the greater wing of the sphenoid bone and a fluid-filled sphenoid sinus. For 3 years, the cerebral cyst remained stable and minimally symptomatic. On her last magnetic resonance imaging, the cyst enlarged and perilesional edema was identified. The patient was treated with an open intracranial approach to explore the cyst. An arachnoid cyst was found which extended into the sphenoid sinus through a defect in the temporal fossa floor. The skull base defect was repaired using a muscle plug and fibrin sealant to obliterate the dural and bony defect. The arachnoid cyst was fenestrated to the basal cisterns.
CONCLUSIONS
Cerebral arachnoid cysts extending into the paranasal sinuses are very rare presenting mostly with rhinorrhea and nasal symptoms. Patients with neurologic symptoms may need intracranial surgery to fenestrate the cyst. Obliteration of the fistula into the paranasal sinus is essential to prevent further complications.
Topics: Aged; Arachnoid Cysts; Female; Humans; Sphenoid Sinus; Temporal Lobe
PubMed: 29597017
DOI: 10.1016/j.wneu.2018.03.119 -
Acta Neurochirurgica May 2020Arachnoid cysts are congenital, benign lesions in the brain and are often incidental radiological findings. Frequently, the arachnoid cysts are left untreated; however,...
INTRODUCTION
Arachnoid cysts are congenital, benign lesions in the brain and are often incidental radiological findings. Frequently, the arachnoid cysts are left untreated; however, recent studies have shown that arachnoid cysts can cause cognitive dysfunction that affect quality of life. Moreover, the function can improve after surgical decompression. Hence, there is controversy regarding symptomatology and treatment effects of arachnoid cysts. The aim of the study was to analyse if arachnoid cysts can cause cognitive impairment and subjective symptoms and if these impairments are reversible after surgical treatment.
MATERIAL AND METHODS
Twenty-one consecutive patients with radiologically confirmed supratentorial arachnoid cysts were cognitively evaluated using a battery of seven neuropsychological tests. Twelve of these patients underwent surgery and were evaluated before and after surgery. The patients were also evaluated with neuropsychological testing after surgery. Further information was extracted from the medical records. The cognitive test results were compared to standard population values using z-test, and the test results from the surgically treated patients were compared before and after surgery using paired t-test.
RESULTS
The surgically treated patients had a statistically significant improvement of neurocognitive test results after surgery in six out of the seven tests (p < 0.05). The total patient group showed lower mean values in all tests when compared to standard population. Statistical significance was, however, only detected in two of the seven tests. All surgically treated patients reported diminished symptoms after surgery.
CONCLUSIONS
The patients with arachnoid cysts presented with cognitive dysfunction compared to the normal population which improved after surgical decompression. Arachnoid cysts should not be considered asymptomatic unless thoroughly evaluated with clinical and neuropsychological work-up.
Topics: Adolescent; Adult; Aged; Arachnoid Cysts; Cognitive Dysfunction; Decompression, Surgical; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Postoperative Period; Quality of Life; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 31960141
DOI: 10.1007/s00701-020-04225-9 -
Archives of Neurology Jan 2000
Topics: Arachnoid Cysts; Cerebrospinal Fluid; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Canal
PubMed: 10634460
DOI: 10.1001/archneur.57.1.128 -
British Journal of Neurosurgery Aug 2014There are only three cases of arachnoid cysts inducing twelfth nerve paresis described in English medical literature. We herein report one more instance. Six weeks after... (Review)
Review
There are only three cases of arachnoid cysts inducing twelfth nerve paresis described in English medical literature. We herein report one more instance. Six weeks after surgery, the patient has almost fully recovered. This case underlines the importance of considering the arachnoid cyst as a possible cause of twelfth nerve paresis.
Topics: Aged; Arachnoid Cysts; Cranial Fossa, Posterior; Humans; Hypoglossal Nerve Diseases; Magnetic Resonance Imaging; Male; Paresis
PubMed: 24138685
DOI: 10.3109/02688697.2013.841851 -
Child's Nervous System : ChNS :... May 1997We report the case of a 5-year-old girl with an enlarging suboccipital mass, a posttraumatic intraosseous arachnoid cyst. Diagnostic work-up revealed that the lesion... (Review)
Review
We report the case of a 5-year-old girl with an enlarging suboccipital mass, a posttraumatic intraosseous arachnoid cyst. Diagnostic work-up revealed that the lesion consisted of an intradiploic arachnoid cyst and an extra-axial occipital pouch that communicated by way of an osseous and dural defect. Surgical repair was undertaken with good results. A search of the current literature has shown only seven previous reports of leptomeningeal cysts situated at the occipital bones, most of them the result of an antecedent skull fracture. A pathogenetic hypothesis is presented comparing the growth of arachnoid intraosseous cysts and the development of meningocencephaloceles.
Topics: Arachnoid Cysts; Child, Preschool; Craniotomy; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Occipital Bone; Postoperative Complications; Skull Fractures; Tomography, X-Ray Computed
PubMed: 9224921
DOI: 10.1007/s003810050088 -
Journal of Neurosurgery. Spine May 2007The authors examine the natural history of a spinal epidural arachnoid cyst and present their experience with its treatment in a 25-year-old man who presented with... (Review)
Review
The authors examine the natural history of a spinal epidural arachnoid cyst and present their experience with its treatment in a 25-year-old man who presented with progressive cauda equina syndrome. Neuroimaging revealed two neighboring sacral epidural cysts. The cysts were completely removed via a sacral S1-4 laminectomy; no communication with the subarachnoid space could be found. The patient's postoperative course was uneventful. He experienced progressive improvement and, finally, complete resolution of symptoms and no recurrence of the cyst. Nabors Type I sacral epidural arachnoid cysts are rare; in some cases their origins and the mechanism by which they cause deterioration in the patients' clinical condition are debatable. Findings in the present case support the idea that some of these cysts are noncommunicating but progressive in their clinical presentation. This lesion type is also known to occur intracranially. A brief review of the literature is provided.
Topics: Arachnoid Cysts; Diagnosis, Differential; Humans; Infant; Magnetic Resonance Imaging; Male; Sacrum
PubMed: 17542517
DOI: 10.3171/spi.2007.6.5.473