Acil Servise Baş Ağrısı Şikayeti ile Başvuran Sağ Temporal Lob Yerleşimli Dev Araknoid Kist: Olgu Sunumu

Öz

Araknoid kistler; intrakraniyal kitlelerin yaklaşık %1’ini oluşturur ve sıklıkla ekstra-aksiyel bölgede dura ile beyin arasında yerleşimli kistik lezyonlardır. Genellikle erken yaşlarda semptom verirler. Artan yaşla birlikte semptom verme insidansı azalır hatta bazı dev araknoid kistler tamamen asemptomatik olup, otopsi esnasında insidental olarak tespit edilirler. Acil servise baş ağrısı şikayeti ile başvuran ve sağ temporal yerleşimli araknoid kist teşhis edilen, sonrasında da opere edilen bir olgu sunduk. On yedi yaşında erkek hasta, üç-dört yıldan beri ara sıra olan baş ağrısı şikayetinin şiddetlenmesi üzerine acil servisimize başvurdu. Nörolojik muayenesi normal olarak saptanan hastanın çekilen beyin tomografisinde sağ beyin hemisferinin yaklaşık yarısını kaplayan, lateral ventriküle bası yapan kistik lezyon saptandı. Ayırıcı tanı için yapılan difüzyon manyetik rezonans görüntülemede lezyonun araknoid kist ile uyumlu olduğu saptandı. Araknoid kistleri asemptomatik olabildikleri gibi non-spesifik semptomlara da yol açabilirler. Bu kistlerin cerrahi tedavi endikasyonları ve yöntemleri halen tartışmalıdır.

Anahtar Kelimeler

• Araknoid kist, baş ağrısı, acil servis

Giant Arachnoid Cyst Located on Right Temporal Lobe Applied to the Emergency Department With Complaint of Headache: A Case Report

Öz

Arachnoid cysts constitute approximately 1% of intracranial masses and they are cystic lesions usually located on extraaxial region between dura and the brain. They usually show symptoms in the early years. Incidence of showing symptoms decrease with increasing age, some giant arachnoid cysts even become completely asymptomatic and they are detected incidentally during autopsies. Herein we reported a case who applied to the emergency department with complaint of headache and diagnosed as arachnoid cyst located on right temporal lobe and operated on thereafter. A 17-year-old male patient suffered from headache occasionally was applied to our emergency department as his headache aggravated. A cystic lesion occupying almost half of the right hemisphere and impressing on lateral ventricle was detected on computed cranial tomography of the patient whose neurological examination was found normal. The lesion was found to be consistent with arachnoid cyst on diffusion magnetic resonance ımaging carried out for differential diagnosis. Arachnoid cysts can lead to non-specific symptoms as well as they can be asymptomatic. Indications and methods of surgical treatment for these cysts are currently controversial

Anahtar Kelimeler

• Arachnoid cyst, headache, emergency department

Kaynakça

1. Rengachary SS, Kennedy JD. In: Intracranial Arachnoid and Epen- dymal Cysts. Wilkins RH, Rengachary SS eds. Neurosurgery, vol- ume 3, second edition. New York: McGraw Hill, 1996: 3709-28.
2. Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus 2007;22:E7.
3. Alkilic-Genauzeau I, Boukobza M, Lot G, George B, Merland JJ. CT and MRI features of arachnoid cyst of the petrous apex: report of 3 cases J Radiol 2007;88:1179-83.
4. Boutarbouch M, El Ouahabi A, Rifi L, Arkha Y, Derraz S, El Khamlichi A. Management of intracranial arachnoid cysts: Institu- tional experience with initial 32 cases and review of the literature. Clin Neurol Neurosurg 2007;21:207-13.
5. Weber R, Voit T, Lumenta C, Lenard HG. Spontaneous regression of a temporal arachnoid cyst. Child’s Nerv Syst 1991;7:414-5.
6. Kjos BO, Brant-Zawadzki M, Kucharczyk W. Cystic intracranial lesions: magnetic resonance imaging. Radiology 1985;155:363-9.
7. Schroeder HWS, Gaab MR, Niendorf WR. Neuroendoscopic ap- proach to arachnoid cysts. J Neurosurg 1996;85:293-8.
8. Erdinçler P, Kaynar MY, Bozkus H, Ciplak N. Posterior fossa arachnoid cysts. British Journal of Neurosurgery 1999;13:10-7.

9. Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G. In- fratentorial arachnoid cysts. J Neurosurg 1985;63:210-7.
10. Samii M, Carvalho GA, Schuhmann MU, Matthies C. Arachnoid cysts of the posterior fossa. Surg Neurol 1999;51:376-82.