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arachnoid_cyst

Arachnoid cyst

Arachnoid cysts are cerebrospinal fluid covered by arachnoid mater and collagen that may develop between the surface of the brain and the cranial base or on the arachnoid membrane.

Epidemiology

Most cases begin during infancy; however, onset may be delayed until adolescence.

The prevalence of arachnoid cysts in children is 1-3%. They are more frequent in boys. They can be located intracranially or in the spine 1).

Etiology

They are a rare condition thought to be congenital in nature.

see Arachnoid Cyst associated chronic subdural hematoma

Classification

Clinical Features

They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage.

Treatment

Treatment of intracranial arachnoid cysts remains controversial based on their variable presentation.

Treatment options include CSF shunting, endoscopic fenestration, or craniotomy and open fenestration for larger cysts.

Neuroendoscopic treatment has been recommended for patients who develop symptoms resulting from the cyst location.

Complications

Occasionally, hydrocephalus is associated due to a change in CSF circulatory dynamics.

see Hydrocephalus associated to midline arachnoid cysts

Hygromas

Hemorrhage

Subdural hematomas, and-more rarely-intraparenchymal hemorrhage. Hemorrhagic complications of arachnoid cysts have been reported, extensively presenting with subdural or intracystic hematoma after trauma, but presentation with extradural hemorrhage is very rare.

Brain parenchyma containing an arachnoid cyst is vulnerable to trauma and increases the risk of serious hemorrhagic complications. The abnormal shape of the head should be considered as an indication for a computerized tomography scan in cases of mild head injury 2).

A case of an 18-year-old female patient who suffered an ipsilateral hemorrhagic infarction after craniotomy for open fenestration of an arachnoid cyst 3).

It is important to be aware of these complications so that patients with arachnoid cysts are appropriately investigated when presenting with neurological symptoms 4).

1)
Candela S, Puerta P, Alamar M, Barcik U, Guillén A, Muchart J, García-Fructuoso G, Ferrer-Rodríguez E. [Epidemiology and classification of arachnoid cysts in children]. Neurocirugia (Astur). 2015 Apr 2. pii: S1130-1473(15)00030-5. doi: 10.1016/j.neucir.2015.02.007. [Epub ahead of print] Spanish. PubMed PMID: 25843209.
2)
Seddighi A, Seddighi AS, Zali AR, Baqdashti HR. Presentation of a minimally symptomatic large extradural hematoma in a patient with an arachnoid cyst: a case report and review of the literature. J Med Case Rep. 2011 Dec 19;5:581. doi: 10.1186/1752-1947-5-581. PubMed PMID: 22182235; PubMed Central PMCID: PMC3339374.
3)
Auschwitz T, DeCuypere M, Khan N, Einhaus S. Hemorrhagic infarction following open fenestration of a large intracranial arachnoid cyst in a pediatric patient. J Neurosurg Pediatr. 2014 Dec 5:1-4. [Epub ahead of print] PubMed PMID: 25479577.
4)
Pascoe HM, Phal PM, King JA. Progressive post traumatic tearing of an arachnoid cyst membrane resulting in intracystic and subdural haemorrhage. J Clin Neurosci. 2015 Mar 10. pii: S0967-5868(15)00007-7. doi: 10.1016/j.jocn.2014.12.006. [Epub ahead of print] PubMed PMID: 25769260.
arachnoid_cyst.txt · Last modified: 2018/06/04 12:38 by administrador