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Arachnoid Cysts

Year 2007, Volume: 8 Issue: 1, 51 - 55, 01.04.2007

Abstract

Arachnoid cysts are cavities with a content similar to cerebrospinal fluid, frequently communicating with the subarachnoid space. They make up 1% of the intracranial space occupying lesions. They are developmental anomalies which may be clinically asymptomatic. The most frequent clinical findings are headache, macrocephaly, epileptic seizures, focal nerological signs and intracranial hypertansion. Rarely they cause optic neuritis, endocrinological dysfunction, cerebellar dysfunction, hemifascial spasm. They are most commonly located in the middle fossa of the cranium. Subdural hematomas and hygromas are infrequently encountered complications of arachnoid cysts of the middle cranial fossa. Spinal arachnoid cysts are mostly diagnosed accidentally or they may present with limb weakness, neuropathic pain, parestesia or myelopathy. In this review localization, clinical features, some unusual syndromes and treatment options of arachnoid cysts are discussed.

References

  • 1. Menkes JH. Arachnoidal Cysts in Sarnat H.B, Menkes HJ, editors. Child Neurology. 6th. ed. Lippincott Williams andWilkins, Philadelphia, 2000:377-378
  • 2. Yalcin AD, Öncel C, Kaymaz A, Kuloglu N, Forta H. Evidence against association between arachnoid cysts and epilepsy. Epilepsy Res 2002; 49:255-60
  • 3. Choi.U.C, Kim S.D. Pathogenesis of arachnoid cyst: Congenital or traumatic? Pediatric Neurosurgery 1998;29:260-266.
  • 4. Margred G, Von Cramon Y, Frithjof K, Christopf P Do quiescent arachnoid cysts alter CNS functional organization?: A fMRI and morphometric study. Neurology 2002;59:1935-1939.
  • 5. Ibarra R, Kesava P.P. Role of MR Imaging in the diagnosis of complicated arachnoid cyst. Pediatri Radiolo 2000;30:329-331.
  • 6. Wester, Knut. Peculiarities of intrcranial arachnoid cysts: Location, sidedness and sex distribution in 126 consecutive patients. Neurosurgery 1999;45:775.
  • 7. Rengachary S.S, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts: J Neuropathol Exp Neurol 1981;40:61-83.
  • 8. Harding BN; Copp AJ. Malformations. In: Graham DI, Lantos PL editors, Greenfield's Neuropathology, 7th ed. Oxford University Press 2002; 451-452.
  • 9. Gosalakkal JA. Intracranial arachnoid cysts in children: a review of pathogenesis, clinical features, and management. Pediatr Neurol 2002; 26:93-8.
  • 10. Wang P.J, Lin H.C, Liu H.M, Tseng C.L, Shen Y.Z. Intracranial arachnoid cysts in children: related signs and associated anomalies. Pediatr Neurolo 1998;19:100-104.
  • 11. Passero S, Filosomi G, Cioni R, Venturi C, Volpini B. Arachnoid cysts of the middle cranial fossa: a clinical, radiological and follow-up study. Acta Neurol Scand 1990;82:94-100.
  • 12. Lütcherath V, Waaler P.E., Jellum E, Wester K. Children with bilateral temporal arachnoid cysts may have glutaric aciduria type 1 (GAT1); operation without knowing that may be harmful. Acta Neurochirurgica 2000;142:1025-1030.
  • 13. Erman T, Göçer İ, Tuna M,Ergin M, Zorludemir S, Çetinalp E. Intracranial arachnoid cysts: clinical features and management of 35 cases and review of the literature. Neurosurgery Quarterly 2004;14:84-89.
  • 14. Arai H, Sato K, Wachi A, Okuda O, Takeda N. Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting. Neurosurgery 1996;39:1108-12.
  • 15. De Volder AG, Michel C, Thauvoy C, Willems G, Ferriere G. Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J Neurol Neurosurg Psychiatry 1994;57:296-300.
  • 16. Stowe LA, Go KG, Pruim J, den Dunnen W, Meiners LC, Paans AM. Language localization in cases of left temporal lobe arachnoid cyst: evidence against interhemispheric reorganization. Brain Lang 2000;75:347-58.
  • 17. Shin JL, Asa SL, Woodhouse LJ, Smyth HS, Ezzat S. Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst. J Clin Endocrinol Metab 1999; 84:3972-82.
  • 18. Mohn A, Schoof E, Fahlbusch R, Wenzel D, Dorr HG. The endocrine spectrum of arachnoid cysts in childhood. Pediatr Neurosurg 1999; 31:316-21.
  • 19. Murakami M, Okumura H, Kakita K. Recurrent intrasellar arachnoid cyst. Neurol Med Chir (Tokyo) 2003; 43:312-5.
  • 20. Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G. Infratentorial arachnoid cysts. J Neurosurg 1985; 63:210-7.
  • 21. Nadkarni T, Hande A, Nagpal R. Arachnoid cyst within the fourth ventricle--a case report. Br J Neurosurg 1995;9:675-8.
  • 22. Shukla R, Sharma A, Vatsal DK. Posterior fossa arachnoid cyst presenting as high cervical cord compression.Br J Neurosurg 1998;12:271-3.
  • 23. Jallo GI, Woo HH, Meshki C, Epstein FJ, Wisoff JH. Arachnoid cysts of the cerebellopontine angle: diagnosis and surgery.Neurosurgery 1997;40:31-7.
  • 24. Cheung SW, Broberg TG, Jackler RK. Petrous apex arachnoid cyst: radiographic confusion with primary cholesteatoma.Am J Otol 1995;16:690-4.
  • 25. Callaway MP, Renowden SA, Lewis TT, Bradshaw J, Malcolm G, Coakham H. Middle cranial fossa arachnoid cysts: not always a benign entity. Br J Radiol 1998;71:441-3.
  • 26. Goda M, Tashima A, Isono M, Hori S, Kimba Y. A case of hypothalamic hamartoma associated with arachnoid cyst. Childs Nerv Syst 1999;15:490-2.
  • 27. Krupp W, Dohnert J, Kellermann S, Seifert V.Intradiploic arachnoid cyst with extensive deformation of craniofacialosseous structures: case report. Neurosurgery 1999;44:868-70.
  • 28. Millichap JG. Temporal lobe arachnoid cyst-attention deficit disorder syndrome: role of the electroencephalogram in diagnosis. Neurology 1997;48:1435-9.
  • 29. Akor C, Wojno TH, Newman NJ, Grossniklaus HE. Arachnoid cyst of the optic nerve: report of two cases and review of the literature.Ophthal Plast Reconstr Surg 2003;19:466-9.
  • 30. Kobayashi E, Bonilha L, Li LM, Cendes F. Temporal lobe hypogenesis associated with arachnoid cyst in patients with epilepsy. Arq Neuropsiquiatr 2003;61(2B):327-9.
  • 31. Caruso R, Salvati M, Cervoni L. Primary intracranial arachnoid cyst in the elderly. Neurosurg Rev 1994;17:195-8.
  • 32. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, longterm follow-up, and review of the literature. Neurosurgery 1997;40:483-90.
  • 33. Mori T, Fujimoto M, Sakae K, Sakakibara T, Shin H, Yamaki T, Ueda S. Disappearance of arachnoid cysts after head injury. Neurosurgery 1995;36:938-41.
  • 34. Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol 2005;63:550-3.
  • 35. Morioka T, Nishio S, Ishibashi H, Fukui M. Relationship between arachnoid cysts and seizure foci.Epilepsia 1998;39:804-5.
  • 36. Rengachary SS. Spinal arachnoid cysts. In: Rengachary SS,WilkinsRH, Neurosurgery. Mc Graw Hill, 1985:2068-2069.
  • 37. Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003;60:49-55.
  • 38. Takeuchi A, Miyamoto K, Sugiyama S, Saitou M, Hosoe H, Shimizu K. Spinal arachnoid cysts associated with syringomyelia: report of two cases and a review of the literature. J Spinal Disord Tech 2003;16:207-11.
  • 39. Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003;60:49-55.
  • 40. Safriel YI, Sanchez G, Jhaveri HS. Giant anterior cervicothoracic arachnoid cyst. Spine 2002;27(15):E366-8.
  • 41. Sharma A, Sayal P, Badhe P, Pandey A, Diyora B, Ingale H. Spinal intramedullary arachnoid cyst.Indian J Pediatr 2004;71:e65-7.
  • 42. Cheung SW, Broberg TG, Jackler RK.Petrous apex arachnoid cyst: radiographic confusion with primary cholesteatoma.Am J Otol 1995;16:690-4.
  • 43. Heier LA, Zimmerman RD, Amster JL, Gandy SE, Deck MD. Magnetic resonance imaging of arachnoid cysts. Clin Imaging 1989;13:281-91.
  • 44. Hakyemez B, Yıldız H, Ergin N, Uysal S, Parlak M. Epidermoid kistlerin araknoid kistlerden ayrımında FLAIR ve difüzyon ağırlıklı MRG bulguları.Türk Tanısal ve Girişimsel Radyoloji Derneği 2003; 9:418- 426.
  • 45. Ibarra R, Kesava PP. Role of MR imaging in the diagnosis of complicated arachnoid cyst. Pediatr Radiol 2000;30:329-31.
  • 46. Choong CT, Lee SH.Subdural hygroma in association with middle fossa arachnoid cyst: acetazolamide therapy Brain Dev 1998;20:319-22.
  • 47. Longatti P, Marton E, Billeci D.Acetazolamide and corticosteroid therapy in complicated arachnoid cyst. Childs Nerv Syst 2005;21:1061-4.
  • 48. Helland CA, Wester K. Arachnoid cysts in adults: longterm follow-up of patients treated with internal shunts to the subdural compartment. Surg Neurol 2006;66:56-61.
  • 49. Greenfield JP, Souweidane MM. Endoscopic management of intracranial cysts. Neurosurg Focus 2005 Dec 15;19(6):E7.

ARAKNOİD KİSTLER

Year 2007, Volume: 8 Issue: 1, 51 - 55, 01.04.2007

Abstract

Araknoid kistler beyin-omurilik sıvısı (BOS) benzeri sıvı içeren, subaraknoidal boşlukla ilişkisi olan kistikkavitelerdir. Beyinde tüm yer kaplayan oluşumların %1'ini oluştururlar. Çoğunlukla asemptomatiktirler. Tüm yaşgruplarında gelişebilmekle birlikte genellikle çocukluk çağına kadar oluşmaktadırlar. Başağrısı, makrosefali,konvülziyon, fokal nörolojik belirtiler, kafa içi basınç artışı gibi bulgular verebilirler. Nadiren endokrinanormallikler, optik nörit, serebellar disfonksiyon, hidrosefali, hemifasyal spazma neden olurlar. En sıkgörüldükleri bölge orta çukurdur. Orta çukur yerleşimli araknoid kistlerde nadiren subdural hematom ve higromagibi komplikasyonlar gelişebilmektedir. Spinal araknoid kistler genellikle tesadüfen tesbit edilirler. Ekstremitegüçsüzlüğü, nöropatik ağrı, parestezi, myelopati ile prezente olabilirler. Bu derlemede serebral ve spinal araknoidkistlerin yerleşimi, klinik bulguları, bazı nadir klinik görünüm şekilleri, görüntüleme yöntemleri ve tedavisi anlatılacaktır

References

  • 1. Menkes JH. Arachnoidal Cysts in Sarnat H.B, Menkes HJ, editors. Child Neurology. 6th. ed. Lippincott Williams andWilkins, Philadelphia, 2000:377-378
  • 2. Yalcin AD, Öncel C, Kaymaz A, Kuloglu N, Forta H. Evidence against association between arachnoid cysts and epilepsy. Epilepsy Res 2002; 49:255-60
  • 3. Choi.U.C, Kim S.D. Pathogenesis of arachnoid cyst: Congenital or traumatic? Pediatric Neurosurgery 1998;29:260-266.
  • 4. Margred G, Von Cramon Y, Frithjof K, Christopf P Do quiescent arachnoid cysts alter CNS functional organization?: A fMRI and morphometric study. Neurology 2002;59:1935-1939.
  • 5. Ibarra R, Kesava P.P. Role of MR Imaging in the diagnosis of complicated arachnoid cyst. Pediatri Radiolo 2000;30:329-331.
  • 6. Wester, Knut. Peculiarities of intrcranial arachnoid cysts: Location, sidedness and sex distribution in 126 consecutive patients. Neurosurgery 1999;45:775.
  • 7. Rengachary S.S, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts: J Neuropathol Exp Neurol 1981;40:61-83.
  • 8. Harding BN; Copp AJ. Malformations. In: Graham DI, Lantos PL editors, Greenfield's Neuropathology, 7th ed. Oxford University Press 2002; 451-452.
  • 9. Gosalakkal JA. Intracranial arachnoid cysts in children: a review of pathogenesis, clinical features, and management. Pediatr Neurol 2002; 26:93-8.
  • 10. Wang P.J, Lin H.C, Liu H.M, Tseng C.L, Shen Y.Z. Intracranial arachnoid cysts in children: related signs and associated anomalies. Pediatr Neurolo 1998;19:100-104.
  • 11. Passero S, Filosomi G, Cioni R, Venturi C, Volpini B. Arachnoid cysts of the middle cranial fossa: a clinical, radiological and follow-up study. Acta Neurol Scand 1990;82:94-100.
  • 12. Lütcherath V, Waaler P.E., Jellum E, Wester K. Children with bilateral temporal arachnoid cysts may have glutaric aciduria type 1 (GAT1); operation without knowing that may be harmful. Acta Neurochirurgica 2000;142:1025-1030.
  • 13. Erman T, Göçer İ, Tuna M,Ergin M, Zorludemir S, Çetinalp E. Intracranial arachnoid cysts: clinical features and management of 35 cases and review of the literature. Neurosurgery Quarterly 2004;14:84-89.
  • 14. Arai H, Sato K, Wachi A, Okuda O, Takeda N. Arachnoid cysts of the middle cranial fossa: experience with 77 patients who were treated with cystoperitoneal shunting. Neurosurgery 1996;39:1108-12.
  • 15. De Volder AG, Michel C, Thauvoy C, Willems G, Ferriere G. Brain glucose utilisation in acquired childhood aphasia associated with a sylvian arachnoid cyst: recovery after shunting as demonstrated by PET. J Neurol Neurosurg Psychiatry 1994;57:296-300.
  • 16. Stowe LA, Go KG, Pruim J, den Dunnen W, Meiners LC, Paans AM. Language localization in cases of left temporal lobe arachnoid cyst: evidence against interhemispheric reorganization. Brain Lang 2000;75:347-58.
  • 17. Shin JL, Asa SL, Woodhouse LJ, Smyth HS, Ezzat S. Cystic lesions of the pituitary: clinicopathological features distinguishing craniopharyngioma, Rathke's cleft cyst, and arachnoid cyst. J Clin Endocrinol Metab 1999; 84:3972-82.
  • 18. Mohn A, Schoof E, Fahlbusch R, Wenzel D, Dorr HG. The endocrine spectrum of arachnoid cysts in childhood. Pediatr Neurosurg 1999; 31:316-21.
  • 19. Murakami M, Okumura H, Kakita K. Recurrent intrasellar arachnoid cyst. Neurol Med Chir (Tokyo) 2003; 43:312-5.
  • 20. Galassi E, Tognetti F, Frank F, Fagioli L, Nasi MT, Gaist G. Infratentorial arachnoid cysts. J Neurosurg 1985; 63:210-7.
  • 21. Nadkarni T, Hande A, Nagpal R. Arachnoid cyst within the fourth ventricle--a case report. Br J Neurosurg 1995;9:675-8.
  • 22. Shukla R, Sharma A, Vatsal DK. Posterior fossa arachnoid cyst presenting as high cervical cord compression.Br J Neurosurg 1998;12:271-3.
  • 23. Jallo GI, Woo HH, Meshki C, Epstein FJ, Wisoff JH. Arachnoid cysts of the cerebellopontine angle: diagnosis and surgery.Neurosurgery 1997;40:31-7.
  • 24. Cheung SW, Broberg TG, Jackler RK. Petrous apex arachnoid cyst: radiographic confusion with primary cholesteatoma.Am J Otol 1995;16:690-4.
  • 25. Callaway MP, Renowden SA, Lewis TT, Bradshaw J, Malcolm G, Coakham H. Middle cranial fossa arachnoid cysts: not always a benign entity. Br J Radiol 1998;71:441-3.
  • 26. Goda M, Tashima A, Isono M, Hori S, Kimba Y. A case of hypothalamic hamartoma associated with arachnoid cyst. Childs Nerv Syst 1999;15:490-2.
  • 27. Krupp W, Dohnert J, Kellermann S, Seifert V.Intradiploic arachnoid cyst with extensive deformation of craniofacialosseous structures: case report. Neurosurgery 1999;44:868-70.
  • 28. Millichap JG. Temporal lobe arachnoid cyst-attention deficit disorder syndrome: role of the electroencephalogram in diagnosis. Neurology 1997;48:1435-9.
  • 29. Akor C, Wojno TH, Newman NJ, Grossniklaus HE. Arachnoid cyst of the optic nerve: report of two cases and review of the literature.Ophthal Plast Reconstr Surg 2003;19:466-9.
  • 30. Kobayashi E, Bonilha L, Li LM, Cendes F. Temporal lobe hypogenesis associated with arachnoid cyst in patients with epilepsy. Arq Neuropsiquiatr 2003;61(2B):327-9.
  • 31. Caruso R, Salvati M, Cervoni L. Primary intracranial arachnoid cyst in the elderly. Neurosurg Rev 1994;17:195-8.
  • 32. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, longterm follow-up, and review of the literature. Neurosurgery 1997;40:483-90.
  • 33. Mori T, Fujimoto M, Sakae K, Sakakibara T, Shin H, Yamaki T, Ueda S. Disappearance of arachnoid cysts after head injury. Neurosurgery 1995;36:938-41.
  • 34. Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol 2005;63:550-3.
  • 35. Morioka T, Nishio S, Ishibashi H, Fukui M. Relationship between arachnoid cysts and seizure foci.Epilepsia 1998;39:804-5.
  • 36. Rengachary SS. Spinal arachnoid cysts. In: Rengachary SS,WilkinsRH, Neurosurgery. Mc Graw Hill, 1985:2068-2069.
  • 37. Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003;60:49-55.
  • 38. Takeuchi A, Miyamoto K, Sugiyama S, Saitou M, Hosoe H, Shimizu K. Spinal arachnoid cysts associated with syringomyelia: report of two cases and a review of the literature. J Spinal Disord Tech 2003;16:207-11.
  • 39. Wang MY, Levi AD, Green BA. Intradural spinal arachnoid cysts in adults. Surg Neurol 2003;60:49-55.
  • 40. Safriel YI, Sanchez G, Jhaveri HS. Giant anterior cervicothoracic arachnoid cyst. Spine 2002;27(15):E366-8.
  • 41. Sharma A, Sayal P, Badhe P, Pandey A, Diyora B, Ingale H. Spinal intramedullary arachnoid cyst.Indian J Pediatr 2004;71:e65-7.
  • 42. Cheung SW, Broberg TG, Jackler RK.Petrous apex arachnoid cyst: radiographic confusion with primary cholesteatoma.Am J Otol 1995;16:690-4.
  • 43. Heier LA, Zimmerman RD, Amster JL, Gandy SE, Deck MD. Magnetic resonance imaging of arachnoid cysts. Clin Imaging 1989;13:281-91.
  • 44. Hakyemez B, Yıldız H, Ergin N, Uysal S, Parlak M. Epidermoid kistlerin araknoid kistlerden ayrımında FLAIR ve difüzyon ağırlıklı MRG bulguları.Türk Tanısal ve Girişimsel Radyoloji Derneği 2003; 9:418- 426.
  • 45. Ibarra R, Kesava PP. Role of MR imaging in the diagnosis of complicated arachnoid cyst. Pediatr Radiol 2000;30:329-31.
  • 46. Choong CT, Lee SH.Subdural hygroma in association with middle fossa arachnoid cyst: acetazolamide therapy Brain Dev 1998;20:319-22.
  • 47. Longatti P, Marton E, Billeci D.Acetazolamide and corticosteroid therapy in complicated arachnoid cyst. Childs Nerv Syst 2005;21:1061-4.
  • 48. Helland CA, Wester K. Arachnoid cysts in adults: longterm follow-up of patients treated with internal shunts to the subdural compartment. Surg Neurol 2006;66:56-61.
  • 49. Greenfield JP, Souweidane MM. Endoscopic management of intracranial cysts. Neurosurg Focus 2005 Dec 15;19(6):E7.
There are 49 citations in total.

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Journal Section Collection
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Çağatay Öncel This is me

Publication Date April 1, 2007
Published in Issue Year 2007 Volume: 8 Issue: 1

Cite

EndNote Öncel Ç (April 1, 2007) Arachnoid Cysts. Meandros Medical And Dental Journal 8 1 51–55.