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Acta Neuropathologica Communications Mar 2020Brain tumors represent the second most frequent etiology in patients with focal seizure onset before 18 years of age and submitted to epilepsy surgery. Hence, this... (Review)
Review
Brain tumors represent the second most frequent etiology in patients with focal seizure onset before 18 years of age and submitted to epilepsy surgery. Hence, this category of brain tumors, herein defined as low-grade, developmental, epilepsy-associated brain tumors (LEAT) is different from those frequently encountered in adults as (A): 77% of LEAT occur in the temporal lobe; (B): the vast majority of LEAT are of low malignancy and classified as WHO I°; (C): LEAT are often composed of mixed glial and neuronal cell components and present with variable growth patterns including small cysts or nodules; (D): LEAT do not share common gene driving mutations, such as IDH1 or 1p/19q co-deletions. Characteristic entities comprise the ganglioglioma (GG), the dysembryoplastic neuroepithelial tumor (DNT), the angiocentric glioma (AG), the isomorphic diffuse glioma (IDG) and the papillary glio-neuronal tumor (PGNT), representing 73.2% of 1680 tumors collected in a large German series of 6747 patients submitted to epilepsy surgery. In the realm of exciting discoveries of genetic drivers of brain tumors new genes have been also reported for LEAT. BRAF V600E mutations were linked to GG with CD34 expression, FGFR1 mutations to DNT, MYB alterations to AG and also IDG and PRKCA fusions to PGNT, suggesting the possibility to also develop a genetically driven tumor classification scheme for LEAT. Rare availability of LEAT in a single center is a challenging obstacle, however, to systematically unravel the neurobiological nature and clinical behavior of LEAT. Other challenges in need of clarification include malignant tumor progression of LEAT entities, seizure relapse in patients following bulk tumor resection and the controversial issue of associated focal cortical dysplasia as additional pathomechanism. In order to advance our understanding and promote reliable diagnostic work-up of LEAT, we recommend, therefore, international collaboration to achieve our goals.
Topics: Arachnoid Cysts; Astrocytoma; Brain Neoplasms; Central Nervous System Cysts; Dermoid Cyst; Epidermal Cyst; Epilepsies, Partial; Ganglioglioma; Humans; Molecular Diagnostic Techniques; Neoplasm Grading; Neoplasms, Neuroepithelial; Oligodendroglioma; Protein Kinase C-alpha; Proto-Oncogene Proteins; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins c-myb; Receptor, Fibroblast Growth Factor, Type 1; Trans-Activators
PubMed: 32151273
DOI: 10.1186/s40478-020-00904-x -
Cureus Sep 2017Few case reports discuss suspected psychiatric disturbances secondary to arachnoid cysts. To the best of our knowledge, psychosis from arachnoid cysts has not been...
Few case reports discuss suspected psychiatric disturbances secondary to arachnoid cysts. To the best of our knowledge, psychosis from arachnoid cysts has not been reported in the recent literature. This case report discusses our experience with a 55-year-old male patient who manifested multiple psychotic episodes suspected in association with an arachnoid cyst. During the initial examinations, a computed tomography (CT) scan of his head revealed a relatively large left anterior superior arachnoid cyst with a mass effect on the frontal lobe. Despite multiple trials of combinations of mood stabilizers and psychotropic medications, the patient continued to deteriorate. We ordered a repeat CT of his head along with a magnetic resonance image and consulted a neurosurgeon for a possible surgical intervention. The neurosurgeon concluded that the patient's psychiatric symptoms were unrelated to the arachnoid cyst. While we were unable to determine the etiology of our patient's psychosis, we believe that the arachnoid cyst played at least some part, as evidenced by reports in the literature. Future advancements in radiological technology may allow for a better exploration of the causal relationship between psychiatric illnesses and brain lesions.
PubMed: 29188151
DOI: 10.7759/cureus.1707 -
Cureus Apr 2018Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often... (Review)
Review
Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.
PubMed: 29888162
DOI: 10.7759/cureus.2458 -
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 -
Cureus May 2022Retrocerebellar arachnoid cysts are uncommon intracranial tumors, especially rare in adults. Although asymptomatic in the majority of cases, they may cause a variety of...
Retrocerebellar arachnoid cysts are uncommon intracranial tumors, especially rare in adults. Although asymptomatic in the majority of cases, they may cause a variety of symptoms including convulsions. The causal involvement of these cysts in postictal psychosis, however, remains a topic that is not well-explained in the literature. An 85-year-old Asian man presented with recurrent episodes of convulsions for the last seven months along with preceding headaches and postictal psychotic symptoms. MRI of the head revealed a retrocerebellar arachnoid cyst. He was commenced on symptomatic pharmacological therapy after he refused surgical intervention and remained symptom-free till his discharge from the hospital before being eventually lost to follow-up. This case report focuses on the rare occurrence of a retrocerebellar arachnoid cyst with seizures and postictal psychosis and illustrates the necessity of further case studies and research to identify and explore the potential causal relationship between arachnoid cysts and psychosis.
PubMed: 35698697
DOI: 10.7759/cureus.24935 -
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 -
The New England Journal of Medicine Jan 2019
Topics: Arachnoid Cysts; Brain; Child, Preschool; Female; Head; Humans; Magnetic Resonance Imaging; Movement Disorders; Syndrome
PubMed: 30699323
DOI: 10.1056/NEJMicm1808747 -
Cureus Mar 2023Arachnoid cysts are relatively rare and usually asymptomatic. It can only be diagnosed through radiological imaging modalities. Some patients may develop symptoms such...
Arachnoid cysts are relatively rare and usually asymptomatic. It can only be diagnosed through radiological imaging modalities. Some patients may develop symptoms such as seizures, headache, dizziness, or psychiatric symptoms. We present a case of a 25-year-old male, previously healthy, who presented with sudden, repetitive episodes of seizure without regaining his consciousness. Computed tomography (CT) head scan showed a large cystic lesion that showed a rightward midline shift. Treatment was done surgically via endoscopic fenestration, and the patient remained symptom-free for one year. Most arachnoid cysts tend to remain asymptomatic throughout a patient's life span, allowing them to lead everyday normal lives; however, when these symptoms surface, they tend to be of a sudden nature requiring urgent surgical intervention. Our report follows the case of a young patient whose symptoms appear suddenly with triggers that led to status epilepticus. Our patient continued to suffer from multiple seizure attacks despite being on multiple anti-convulsive medications, and his symptoms eventually subsided via surgical intervention.
PubMed: 37102020
DOI: 10.7759/cureus.36552 -
Sao Paulo Medical Journal = Revista... 2019Presence of an arachnoid cyst and a non-ruptured intracystic brain aneurysm is extremely rare. The aim of this paper was to describe a case of a patient with an... (Review)
Review
CONTEXT
Presence of an arachnoid cyst and a non-ruptured intracystic brain aneurysm is extremely rare. The aim of this paper was to describe a case of a patient with an arachnoid cyst and a non-ruptured aneurysm inside it. Clinical, surgical and radiological data were analyzed and the literature was reviewed.
CASE REPORT
A patient complained of chronic headache. She was diagnosed as having a temporal arachnoid cyst and a non-ruptured middle cerebral artery aneurysm inside it. Surgery was performed to clip the aneurysm and fenestrate the cyst.
CONCLUSIONS
This report raises awareness about the importance of intracranial vascular investigation in patients with arachnoid cysts and brain hemorrhage.
Topics: Arachnoid Cysts; Cerebral Angiography; Female; Humans; Intracranial Aneurysm; Magnetic Resonance Imaging; Middle Aged; Middle Cerebral Artery
PubMed: 29267534
DOI: 10.1590/1516-3180.2017.0083290517 -
Middle East African Journal of... 2015Oculocerebrocutaneous or Delleman syndrome is a rare congenital syndrome characterized by microphthalmia/anophthalmia with or without orbital cysts, focal skin defects,...
Oculocerebrocutaneous or Delleman syndrome is a rare congenital syndrome characterized by microphthalmia/anophthalmia with or without orbital cysts, focal skin defects, intracranial cysts and skin appendages. We here report a case of 1-year-old male child with periocular skin tags, lid colobomas, and dermal hypoplasia. The patient had delayed developmental milestones and history of tonic-clonic seizures. Magnetic resonance imaging of the head revealed a large arachnoid cyst, aplastic cerebellar vermis and polymicrographic pattern of the cerebral cortex. A complex cyst of spleen was also noted on abdominal ultrasonography. Orbital cysts depending on the size can be excised or left alone. Neuroimaging evaluation of patients with congenital orbital cysts and skin appendages is emphasized for early and appropriate management.
Topics: Arachnoid Cysts; Central Nervous System Cysts; Coloboma; Cysts; Eye Abnormalities; Eyelids; Fingers; Humans; Infant; Magnetic Resonance Imaging; Male; Orbital Diseases; Skin Abnormalities
PubMed: 25624688
DOI: 10.4103/0974-9233.148363