Arachnoid Cyst Of The Brain - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Arachnoid cyst of the brain

Arachnoid cyst of the brain is a neoplasm of a benign nature, which has the shape of a bladder and is located between the membranes of the brain. Such cysts are filled with cerebrospinal fluid.

As a rule, a person does not know about the presence of a cyst until an MRI of the brain is done, since such formations rarely give any symptoms. The first complaints appear in a patient when the cysts reach impressive sizes. At the same time, they begin to put pressure on the brain tissue, the intracranial pressure rises in a person, which gives characteristic symptoms. Surgical treatment: the cyst is drained, excised, or shunted.

Content:

• Arachnoid cyst - what is it?
• What can be arachnoid cysts?
• Arachnoid cyst symptoms
• Reasons for the formation of arachnoid cyst of the brain
• How to detect?
• How is a cyst treated?
• Forecast and prevention

Arachnoid cyst - what is it?

An arachnoid cyst is a neoplasm limited by the arachnoid or collagen membrane. Cerebrospinal fluid, which is called cerebrospinal fluid, accumulates inside it. The cyst is located between the duplication of the arachnoid membrane. It is due to the place of its localization that this neoplasm received the appropriate name. In the place where the cyst forms, the arachnoid lining of the brain is thickened and has a duplication, that is, it is divided into 2 sheets. It is between them that cerebrospinal fluid can begin to accumulate.

Cysts are usually small in size, although they can swell when filled with cerebrospinal fluid. Such blisters press on the cerebral cortex and cause the corresponding symptoms.

The location of the cyst formation may vary. Its favorite localization is the cerebellopontine angle, the Sylvian groove or the area above the Turkish saddle. As practice shows, about 4% of the population are carriers of such cysts, but most people are not aware of their existence, since there are simply no symptoms. More often, arachnoid cysts are diagnosed in men. An explanation for this has not been found, but scientists believe that there is a relationship between the frequency of head injuries, which are much less common in women. Arachnoid cysts account for about 1% of all brain neoplasms.

What can be arachnoid cysts?

Depending on the origin of the cysts, there are primary and secondary neoplasms. Primary cysts are pathological neoplasms of the brain that are acquired by a person from birth, for example, a Blake's pocket cyst. Congenital cysts are intrauterine malformations, since nerve tissue is laid in the first weeks after conception.

Secondary cysts develop throughout life, appearing after trauma, inflammation or bleeding in the brain area. Most often, collagen fiber predominates in the composition of such cysts.

Depending on the structure of the cyst, complex and simple neoplasms are distinguished. Simple cysts are represented by the poutine membrane and can independently produce cerebrospinal fluid. Complex cysts are included in other tissues, for example, glial cells can be found in them.

Depending on the clinical manifestations of the neoplasm, cysts are distinguished between frozen and progressive cysts. Progressive formations give neurological symptoms, which only intensify over time. The cysts themselves increase in size. Frozen cysts have a latent course and do not grow larger. It is important to distinguish a progressive cyst from a frozen one, as this allows you to decide on further therapeutic tactics.

In addition to the arachnoid cyst, which forms within the cranium, there are retrocerebellar cysts. They are formed in the thickness of the nervous tissue and provoke the appearance of neurological symptoms. Neurons with such cysts die. It is easier to get rid of an arachnoid cyst as it is located outside the brain. While retrocerebellar cysts are located in its thickness.

Arachnoid cyst symptoms

Arachnoid cysts most often do not give out any symptoms. This is true for small neoplasms. In the overwhelming majority of cases, congenital cysts are discovered by chance, during neurosonography through the fontanelle that has not closed in the child. Or they can be diagnosed during an MRI scan for a different pathology. When an infection that affects the brain enters the body, the cyst can make itself felt. Brain trauma, as well as vascular damage and disease, can provoke its growth, which means symptoms.

If the volume of the cerebrospinal fluid located in the cyst cavity begins to increase, this provokes its growth. In this case, symptoms are manifested, indicating an increase in intracranial pressure. Depending on the location of the neoplasm, the patient will begin to worry about the corresponding neurological symptoms. Every fifth person will experience signs of a cyst.

These include:

• A specific headache in the bones of the skull is carnialgia.
• Dizziness.
• Noise in ears.
• Feeling of throbbing in the head.
• Gait disorder.

A spinal cyst can produce symptoms that resemble those of a herniated disc.

An increase in intracranial pressure is accompanied by the following manifestations:

• Severe headaches.
• Painful sensations in the area of the eyeballs.
• Nausea and vomiting. Vomiting often occurs at the peak of the headache and does not bring relief to the person.
• Convulsions.

As the cyst grows, headaches become more intense, they begin to bother a person on an ongoing basis. Nausea manifests itself in the morning, at the same time in most patients vomiting occurs. If a person ignores the manifestations of a cyst, then problems with hearing and vision may arise, the eyes will begin to double, the sensitivity of the limbs and coordination in space worsens, and speech suffers.

Immobilization of one half of the body, a decrease in muscle strength from the side of paresis - these are severe manifestations of an arachnoid cyst that occur only in advanced cases. Episodes of loss of consciousness and seizures are also common in large cysts. Patients may experience hallucinations. In childhood, there is a delay in speech and mental development.

If a person begins to feel worse, then this clearly indicates the growth of the cyst in size. If it becomes very large, then this is associated with the risk of death due to rupture of the cystic cavity.

In addition, a cyst, which over a long period of time compresses the brain structures, will lead to irreversible changes in its tissues. As a result, a person will develop a persistent neurological deficit against the background of degeneration of nerve cells.

Symptoms of an arachnoid cyst, depending on its location:

• An arachnoid cyst, located in the area of the temples, manifests itself as symptoms of increased blood pressure, seizures, impaired sensitivity and motor activity on the side opposite to the site of tumor localization. A temporal arachnoid cyst presents with the same symptoms as a stroke. However, they are less pronounced and progress more slowly.
• If the cyst is located in the region of the posterior cranial fossa, then this is manifested by the clamping of the brain stem. As a result, the patient may experience respiratory and cardiac disorders, paralysis and paresis, worsening coordination, nystagmus develops. When a tumor becomes large, the risk of coma and death of a person from compression of the stem structures increases.
• When the cerebellum is clamped in a person, coordination disorders are primarily observed, gait suffers. Involuntary movements may appear, there are attacks of dizziness, nausea and noise in the head worries.

Reasons for the formation of arachnoid cyst of the brain

If a cyst forms during intrauterine development, then this is due to the effect of pathogenic factors on the fetus.

These include:

• Intrauterine infections: toxoplasmosis, herpes, rubella virus, etc.
• Intoxication of the body of a pregnant woman. The danger is the intake of alcohol, smoking, drug addiction, therapy with drugs that have a teratogenic effect.
• The impact of radiation on the body of the expectant mother.
• Overheating of the body of a pregnant woman. It is recommended to refuse to visit the baths and saunas, not to be in the sun for a long time, not to take hot baths.
• Marfan's syndrome and hypokinesia of the corpus callosum are accompanied by the appearance of arachnoid cysts.

Also, an arachnoid cyst can form during life. The provocative factors are:

• Received TBI: concussion and contusions.
• Previous surgical interventions on the brain.
• Life-long infections: inflammation of the brain, arachnoiditis and meningoencephalitis.
• Postponed intracerebral hemorrhage.

Sometimes the listed risk factors provide the basis for the growth of a congenital brain cyst.

How to detect?

Examination by a neurologist allows us to suspect the presence of a neoplasm in the brain only if the cyst reaches a significant size. Only in this case does it give a certain neurological symptomatology.

Therefore, if the doctor suspects the presence of a cyst, he will refer the patient to the following studies:

• EEG.
• REG.
• Echo-EG.
• MRI or CT have maximum information content and allow you to clarify the diagnosis. The use of contrast-enhanced MRI is especially important. This method makes it possible to distinguish a cyst from a brain tumor.

How is a cyst treated?

If the arachnoid cyst does not grow or develop, then treatment is not required. A person will need to register with a neurologist and undergo an MRI examination every year. This will make it possible to track the growth and development of the cyst, if any.

When a cyst progresses and causes neurologic symptoms, treatment is required. Medication correction comes down to taking medications that normalize cerebral circulation (nootropics, vasotropics, antioxidants). Sometimes the patient is prescribed drugs that dissolve adhesions (Karipain, Longidaza). The help of a surgeon is needed when taking medications does not solve the problem.

Surgical intervention is designed to reduce intracranial pressure, it is implemented in three ways:

• Bypass surgery. The result of this procedure is the formation of pathways for the outflow of cerebrospinal fluid from the cyst cavity into the peritoneal cavity.
• Fenestration. This method involves aspiration of the contents of the cyst with the further creation of holes. They connect the cystic cavity to the ventricle of the brain or the subarachnoid space.
• Drainage of the neoplasm using needle aspiration.

Modern neurosurgeons prefer to use endoscopic interventions, as they have minimal trauma to the brain.

The operation is prescribed only if other methods of treatment are ineffective. In case of hemorrhage in the area of the cyst, or in case of its rupture, removal of the neoplasm is required. The operation is performed by trepanation, which is associated with a number of complications. The rehabilitation period is quite difficult and time consuming.

Forecast and prevention

The prognosis depends on how the cyst of the brain manifests itself. For many years or even throughout her life, she may not give herself away. If the cyst progresses, then the prognosis worsens. Sometimes such neoplasms become the reason that a person gets a disability, or even dies. However, a similar situation is observed only in advanced cases. If the help of the surgeon was timely, then the person will fully recover. However, it is impossible to exclude the risks of its recurrence.

As for preventive measures, they can be as follows:

• Taking care of your health during pregnancy.
• Careful planning of pregnancy.
• Timely treatment of injuries, inflammation and vascular pathologies of the brain.

An arachnoid cyst is not a sentence. Often, people with such neoplasms live their entire lives and are not even aware of their presence. If the cyst begins to manifest itself, then the treatment should not be delayed.

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".