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Fulltext Neuronavigation-guided endoscopic and hodotopic approach to an arachnoid cyst

Idris Z, Nandrajog P, Abdullah JM, Ghani RI, Idris B

Surg Neurol Int, 2013;4:120.
PMID: 24083055 DOI: 10.4103/2152-7806.118492

BACKGROUND: Arachnoid cysts are intraarachnoid benign cystic lesions filled with cerebrospinal fluid and should be treated without incurring further morbidity to the patients.
CASE DESCRIPTION: The authors present a case of a 68-year-old elderly female with a large right fronto-parieto-temporal arachnoid cyst who has been suffering from mild left hemiparesis for the past 4 years and presented with sudden onset of seizures. The 3 Tesla MR system with diffusion tensor imaging (DTI) and MR tractography of the brain showed a large right fronto-parieto-temporal cystic lesion measuring 7 × 5 × 5 cm with a midline shift of 1 cm, suggestive of an arachnoid cyst with surrounding ipsilateral white matter projection pathways and inferior occipito-frontal fasciculus or inferior longitudinal white matter tracts. The cyst was successfully treated with neuronavigation-guided endoscopic and hodotopical approach to fenestrate the arachnoid cyst into the sylvian cistern, avoiding inadvertent injury to major white matter tracts portrayed by DTI. Postoperatively, a repeated computed tomography (CT) scan of the brain revealed a smaller arachnoid cyst with correction of the midline shift. The patient was weaned off from the ventilator and her hemiplegia improved gradually.
CONCLUSION: This case report emphasizes the value of neuronavigation-guided endoscopic and hodotopic approach to fenestrate the intra-axial arachnoid cyst.

Matched MeSH terms: Arachnoid; Arachnoid Cysts
Fulltext A Rare Case of Spinal Extradural Arachnoid Cyst with Cord Compression

Lin LC, Jason R

Asian J Neurosurg, 2018 4 24;13(2):468-470.
PMID: 29682063 DOI: 10.4103/ajns.AJNS_310_16

Spinal extradural arachnoid cysts are rare lesions which typically involve the thoracic spine and are an asymptomatic condition of unknown origin. They may also produce symptoms by compressing the spinal cord or nerve roots. Surgery is the treatment of choice in such lesions, but asymptomatic patients can be managed conservatively. We present a case of symptomatic, probable traumatic origin, spinal arachnoid cyst at our center in Hospital Kuala Lumpur, Malaysia. Magnetic resonance imaging spine showed well-defined, nonenhancing extradural cystic lesion from T5 to T6 vertebrae level compressing spinal cord anteriorly. The patient underwent T5, T6 laminoplasty, T4 partial laminectomy and excision of the cyst. Histologically, the cyst wall comprised of collagen and meningothelial cells. This surgical intervention achieved neurological improvement in terms of motor power in our follow-up of this patient.

Matched MeSH terms: Arachnoid; Arachnoid Cysts
Fulltext Synovial juxtafacet cyst of the spine presenting as radiculopathy

Nizlan MN, Selvakumar K, Looi LM, Kunasegaran R

Malaysian Journal of Medicine and Health Sciences, 2005;1(2):131-134.

Juxtafacet cyst of the spine is a rare occurrence. Reports have described them as synovial cysts; ganglion cysts; extradural cysts as well as degenerative cysts of the spine. Patients may present with radicular pain, motor deficits, sensory disturbances, cauda equina syndrome and even myelopathy. Lumbar juxtafacet cysts may be confused clinically with prolapsed intervertebral discs or other conditions involving nerve root compression such as arachnoid cysts, ependymal cysts, dermoid cysts or teratomatous cysts. In the case of the juxtafacet cyst, surgical excision is usually curative. We report a case of spinal synovial juxtafacet cyst found intraoperatively in a case that was preoperatively diagnosed as prolapsed intervertebral disc. Synovial juxtafacet cyst of the spine should be considered as one of the differential diagnoses in patients, especially in older patients, presenting with nerve root compression.

Matched MeSH terms: Arachnoid Cysts
Fulltext Conversion Symptoms In Schizophrenia: A Case Report

Ting, J.H., Nor Zuraida, Z., Sharmilla, K., Salina, M.

Malaysian Journal of Psychiatry, 2009;18(2):1-5.
MyJurnal

We report a 35 year-old Iranian female who presented with a sudden onset of left sided hemiparesis associated with temporary loss of consciousness of about 3 minutes. Neurological examination revealed a power of 0/5 over the left upper/lower limbs but reflexes were normal and plantar reflex was downgoing and equivocal. A computed tomography scan was done and it revealed mild bilateral frontal atrophy and a temporal arachnoid cyst which was decidedly an incidental finding and it did not have any relation to the clinical presentation. Electroencephalogram and other laboratory findings were all normal. When the psychiatric team interviewed her, it was revealed that the patient had recently experienced a major stressful event just prior to the hemiparesis. On further interview, the patient had complained of delusions of persecution, delusions of reference and also auditory hallucinations for approximately a year prior to admission. There have been only a spatter of reports of conversion symptoms seen in patients with schizophrenia and this is such a case.

Matched MeSH terms: Arachnoid Cysts