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arachnoid cyst (intracranial cyst)
cerebrospinal fluid-filled cysts on the arachnoid membrane
Epidemiology:
1) most cases begin during infancy
2) onset may be delayed until adolescence
4) most often occur in males
Clinical manifestations:
1) symptoms are related to size & location
2) small cysts are generally asymptomatic (incidental finding)
3) large cysts may cause
a) cranial deformation
b) macrocephaly
c) headaches
d) seizures
e) hydrocephalus
f) increased intracranial pressure
g) developmental delay
h) behavioral changes
i) hemiparesis
j) ataxia, falls
Radiology:
- magnetic resonance imaging [1] (image)
Complications:
1) hemorrhage
a) subarachnoid hemorrhage
b) subdural hemorrhage
2) compression of brain structures
Management:
1) treatment is symptomatic
2) neurosurgery
- surgical placement of a shunt may be required to decompress a cyst
- craniectomy (CPT)
3) prognosis
- with treatment most patients do well
- cyst size may not diminish with shunt [1]
General
CNS cyst
References
- de Longpre J
Large Arachnoid Cyst
PMID: 28591531 Free full text
N Engl J Med 2017; 376:2265. June 8, 2017
http://www.nejm.org/doi/full/10.1056/NEJMicm1610483
- National Institute of Neurological Disorders and Stroke (NINDS)
NINDS Arachnoid Cysts Information Page
https://www.ninds.nih.gov/Disorders/All-Disorders/Arachnoid-Cysts-Information-Page