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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Arachnoid cysts of the posterior fossa are rare. When arachnoid cysts are encountered, the presenting symptoms are frequently otologic, with hearing loss and imbalance occurring commonly. Three cases are presented with a previously unreported otologic symptom, that of bilateral hearing loss, which in one case was fluctuant. None of the patients had the common symptoms of unilateral hearing loss and headache. With the advent of computed tomography and magnetic resonance imaging, these cysts may be readily identified, usually with diagnostic imaging alone. Unfortunately there is often a delay in diagnosis because of the vague and fleeting nature of the symptoms. Because no single diagnostic symptom pattern is able to characterize all cases, it is believed computed tomography or magnetic resonance imaging or both are indicated in patients with long-standing otologic complaints--even in the absence of unilateral symptoms. Treatment of posterior fossa arachnoid cysts primarily consists of surgical procedures designed to decompress the cyst. In this series, treatment with diuretics alone resulted in improvement of symptoms during several years of followup, with no evidence of enlargement of the cysts.
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PMID:Diagnosis and treatment of arachnoid cysts of the posterior fossa. 212 20

Two patients with intraventricular arachnoid cysts are reported and a brief review of the relevant literature is presented. Arachnoid cysts are usually extracerebral or extraventricular. Intraventricular arachnoid cysts are rare: including the two cases reported here, only five cases have been described. The following characteristics were noted in these five patients: all were young; headache was the initial symptom in four; the cyst was in the trigone of a lateral ventricle in four; and there was dilatation of the inferior horn in three.
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PMID:Intraventricular arachnoid cyst. Report of two cases. 325 93

Arachnoid cysts of the middle cranial fossa may manifest themselves in several different ways. Most often they remain asymptomatic and are only diagnosed incidentally on computed tomography or at autopsy. When they are symptomatic, headache, nausea, vomiting and seizures are most common in the patients with increased intracranial pressure. Increased intracranial pressure is caused by the ball-valve mechanism of the cyst's membrane which is in communication with the general subarachnoid space or arachnoid cells which contain specialized membranes and enzymes which have secretory activity. A significant number of middle cranial fossa arachnoid cysts are associated with subdural hematoma which may, in turn, be associated with intracystic hemorrhage. We report an unusual case with posttraumatic, isolated intracystic hemorrhage of the arachnoid cyst in the sylvian area without subdural hematoma.
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PMID:Arachnoid cyst with traumatic intracystic hemorrhage unassociated with subdural hematoma. 783 4

Arachnoid cysts very rarely occur within the ventricular system, where no arachnoid tissue exists. We present three cases of intraventricular arachnoid cyst with special reference to its origin. The first patient was a 5-year-old boy who complained of headaches and enlargement of his head. A CT scan revealed obstructive hydrocephalus and a large cystic lesion in the right lateral ventricle. The symptoms resolved after fenestration of the cyst and cystoperitoneal shunt. The second patient was a 49-year-old woman who complained of headache and numbness in her left upper extremity. A CT scan and MRI revealed a large cyst in the trigone of the right lateral ventricle. Fenestration of the cyst wall and cystoperitoneal shunt were performed relieving her complaints. The third patient was a 42-year-old man who complained of frequent seizures and dizziness. A CT scan and MRI demonstrated a moderate size cystic mass in the inferior horn of the right lateral ventricle. The symptoms were improved by partial resection of the cyst wall. Immunohistochemical studies and light microscopy confirmed that the cyst walls were composed of arachnoid membrane, implying that the cysts were arachnoid cysts. CT and MRI in these three cases showed widening of the choroidal fissure bordering the cyst wall, occasionally involving a part of the protruding cyst wall. On enhanced CT and MRI, the choroid plexus in the trigone of ipsilateral lateral ventricle was displaced anterolaterally, implying that the cysts had grown from outside the choroid plexus. Postoperative MRI demonstrated the shrunken cyst wall attached to the choroidal fissure. The surgical findings in case 3 also showed that the cyst wall was attached firmly to the choroid plexus. These findings appeared to indicate that the intraventricular arachnoid cyst originated from the arachnoid layer drawn into the choroidal fissure with choroidal vascular mesenchyme.
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PMID:[Intraventricular arachnoid cyst--on the origin of intraventricular arachnoid cysts]. 895 93

Arachnoid cysts are relatively common lesions encountered in neurosurgical practice. While arachnoid cysts are most commonly observed to remain of fixed volume over time, little is actually known about their natural history and optimal method of treatment. We present 2 young children with middle fossa arachnoid cysts. In 1 child, the cyst enlarged over time, prompting neurosurgical intervention. However, in the other child, the cyst resolved spontaneously without intervention. The child whose cyst enlarged underwent cyst wall fenestration and cyst-peritoneal shunting. For the child whose arachnoid cyst disappeared without treatment, there was no history of trauma or antecedent headache. These 2 cases serve to illustrate in a single report that middle fossa arachnoid cysts can be dynamic in nature, with some growing in size while others spontaneously resolving. In both cases presented, the temporal lobe on the affected side was compressed by the large cyst. Following treatment or spontaneous resolution of the cyst, the temporal lobe reexpanded, suggesting a normal volume of temporal lobe, and not temporal lobe agenesis. In asymptomatic patients with moderate-sized arachnoid cysts such as the ones demonstrated in these case reports, we suggest close follow-up with serial imaging before deciding on a final treatment plan.
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PMID:Middle cranial fossa arachnoid cysts that come and go. Report of two cases and review of the literature. 936 Nov 18

Arachnoid cysts of the posterior fossa are rare lesions that are considered to be mostly congenital in origin. In this article, we retrospectively review 12 patients who underwent surgical treatment for their symptomatic posterior fossa arachnoid cysts. The most common presenting symptoms were gait disturbances and headache. The diagnosis was established on computed tomography or magnetic resonance imaging. Surgery consisted of cyst wall excision with fenestration in nine cases and shunting procedures in three cases. In all cases except one who-died, the postsurgical follow-up neuroradiological investigations showed that the cysts had decreased in size, the cerebellum had re-expanded, and if there was preoperative hydrocephalus, the ventricular size was decreased. The follow-up period ranged from 1 to 11 years. All surviving cases are free of symptoms and no arachnoid cysts recurred. The classification, pathophysiology, differential diagnosis and surgical treatment of infratentorial arachnoid cysts are discussed and the relevant literature is reviewed.
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PMID:Posterior fossa arachnoid cysts. 1049 79

Arachnoid cysts are relatively common occurrences, with the majority being asymptomatic. The safety of an epidural blood patch in a patient with an arachnoid cyst has not been reported. Our patient had a known thoracic arachnoid cyst and required epidural blood patch for a postdural puncture headache. Magnetic resonance imaging obtained following the epidural blood patch demonstrated no alterations of the cyst or spinal cord compression.
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PMID:Epidural blood patch in a patient with an arachnoid cyst. 1188 22

Arachnoid cysts are infra-arachnoidal cerebrospinal fluid collections that are usually asymptomatic. However, they can become acutely symptomatic because of haemorrhage and cyst enlargement, which may result from minor head trauma. The range of symptoms is wide and many are "soft" signs. Diagnosis is important as cysts causing mass effect require surgery. A case is reported of a child presenting with localised headaches after minor head trauma. Computed tomography demonstrated an arachnoid cyst with evidence of haemorrhage, which required surgical intervention. Other cases of arachnoid cyst presenting to our hospital or reported in the literature are reviewed with respect to presenting symptoms and signs. Localised headaches, behavioural or cognitive changes and ataxia are more commonly associated with this disorder than nausea, vomiting, visual disturbances or seizures. This range of symptomatology following minor head trauma may warrant computed tomography when other criteria for this investigation are not met.
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PMID:Haemorrhage into an arachnoid cyst: a serious complication of minor head trauma. 1210 Nov 65

Chronic subdural hematoma (CSDH) tends to occur in elderly patients with a history of mild head injury at a few months prior to the onset of symptoms. Intracranial arachnoid cyst is believed to be congenital and sometimes becomes symptomatic in pediatric patients. These two distinct clinical entities sporadically occur in the same young patient. Twelve of 541 cases of CSDH surgically treated in our institution had associated arachnoid cyst. The clinical and radiological characteristics of the cases of CSDH associated with arachnoid cyst were retrospectively analyzed and compared with those of CSDH without arachnoid cyst. Arachnoid cysts were located in the middle fossa (eight cases), convexity (two cases), and posterior fossa (two cases). Three cysts were less than 20 mm in diameter. The 12 patients with CSDH and arachnoid cyst (mean age 27.8 +/- 19.7 years) were significantly younger (p < 0.001) than the patients with CSDH without arachnoid cyst (69.5 +/- 13.7 years). Five of the 12 patients were pediatric cases (< 15 years old). The clinical symptoms were also significantly different. The most frequent symptom was headache followed by vomiting in the patients with arachnoid cyst, while gait disturbance and hemiparesis predominated in patients without arachnoid cyst. Hematoma evacuation through burr holes improved the symptoms in all patients with arachnoid cyst. We conclude that even a small arachnoid cyst can be a risk factor for CSDH after mild head injury in young patients and symptoms of increased intracranial pressure are common. Hematoma evacuation is adequate at first operation. If the preoperative symptoms persist, additional arachnoid cyst surgery should be considered. The present results also suggest that CSDH formation may be preceded by subdural hygroma caused by the rupture of arachnoid cyst.
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PMID:Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles: twelve cases of chronic subdural hematoma associated with arachnoid cyst. 1248 15

Arachnoid cysts are commonly thought to arise from either congenital defects or trauma. In this article the authors report the spontaneous development of a suprasellar third ventricular arachnoid cyst whose origin was not clearly congenital or traumatic. At the age of 4 months, the patient presented with hypertonia, and a magnetic resonance (MR) imaging study showed no abnormalities. At the age of 2 years, the boy presented with headaches and projectile emesis, symptoms that prompted further imaging studies. An MR image of the brain revealed a suprasellar cyst and obstructive hydrocephalus. The cyst was endoscopically fenestrated, which led to long-term symptom resolution.
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PMID:Spontaneous development of a de novo suprasellar arachnoid cyst. Case report. 1677 80


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