During the period from 1983 to 1999, 12 patients with symptomatic arachnoid cyst were treated. The mean patient age was 20.6 years. The most common location was the middle fossa (10 cases). Initial CT scan revealed associated subdural hygroma in 7 patients and hydrocephalus in one. Clinical symptoms were related to increased intracranial pressure, cranio-megaly and seizure. One infant with a huge arachnoid cyst was treated, using a cystoperitoneal (CP) shunt. Four patients underwent membraectomy. Combination CP shunt and membraectomy was performed in 5 patients. The remaining 2 arachnoid cysts were complicated with subdural hygroma and, initially, they were observed conservatively, but hygroma gradually changed to hematoma. One was treated by irrigation and the other hematoma was spontaneously absorbed. Significant complications included extensive subdural effusion in one patient, contralateral chronic subdural hematoma in two, intracranial hypotension in two, and shunt dependency in one. There were no recurrences during the follow-up period (mean 3.6 years).
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Headache
December 2024
Neurology Department, University Hospital Gregorio Marañón, Madrid, Spain.
Objective: To provide a detailed description of symptomatic nummular headache (NH) and to compare them with primary cases in a large series.
Background: While most published cases of NH are primary headache, some 'secondary' cases have been reported since its initial description. It remains uncertain why identical clinical presentations can result from primary and 'secondary' etiologies.
J Neurosurg Case Lessons
December 2024
Department of Neurosurgery, NYU Langone Health, New York, New York.
Background: Although intracranial arachnoid cysts are often asymptomatic, a small subset of patients develop debilitating symptoms. A cohort of patients with arachnoid cysts with varying presentations underwent endoscopic cystoventriculostomy, with a significant reduction in symptoms.
Observations: Three patients presented with chronic complaints, all involving headache in addition to other symptoms, and were noted to have large intracranial arachnoid cysts on imaging.
Turk Neurosurg
November 2024
Ankara University, Faculty of Medicine, Department of Neurosurgery, Ankara, Türkiye.
Aim: To retrospectively evaluate the cranial magnetic resonance imaging (MRI) features and determine the incidence of intracranial arachnoid cysts (ACs) based on sex, age, location, size, affected side, Galassi type, and their association with hydrocephalus, mega cisterna magna (MCM), bone erosion, and midline brain shift in 15,108 patients during outpatient headache evaluations.
Material And Methods: Between 2012 and 2022, cranial MRI scans of 15,108 adult patients aged 20-70 years undergoing outpatient evaluations for headaches were retrospectively reviewed to analyze the features of ACs detected incidentally. Patients who had previously undergone a craniotomy or craniectomy were excluded from the study.
World Neurosurg
November 2024
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:
Objective: Thoracic dorsal arachnoid webs are intradural membranes that may cause obstruction of cerebrospinal fluid flow and spinal cord compression. Although well recognized, they are rare and there is a paucity of long-term data on their natural history and prognosis. We reviewed radiographic features, surgical indications, and pathologic specimens of patients diagnosed with focal thoracic dorsal arachnoid webs.
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November 2024
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya City, Japan.
Surgical interventions for arachnoid cysts and glioependymal cysts primarily focus on cyst decompression and establishing communication with cerebrospinal fluid spaces. However, a standardized surgical strategy for symptomatic convexity cysts lacking surrounding cerebrospinal fluid space is still lacking due to the limited number of cases. This systematic review aims to evaluate surgical interventions for symptomatic convexity cysts and proposes a safe and effective treatment approach we have developed.
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