Arachnoid cyst of the brain is a difficult treatment and serious consequences. Arachnoid cyst of the brain: why in such a situation it is impossible to delay treatment? Arachnoid cyst of the brain in a child

If you are looking for information on the topic "brain cyst" or the answer to the question "what is a cyst in the brain?", then this article is for you. A cyst in the brain, or rather, an arachnoid cerebrospinal fluid cyst, is a congenital formation that occurs during development as a result of splitting of the arachnoid (arachnoid) membrane of the brain. The cyst is filled with cerebrospinal fluid, a physiological fluid that bathes the brain and spinal cord. True congenital arachnoid cysts should be distinguished from cysts that appear after damage to the brain substance due to traumatic brain injury, infection, or surgery.

Arachnoid cyst ICD10 code G93.0 (cerebral cyst), Q04.6 (congenital cerebral cysts).

Classification of arachnoid cerebrospinal fluid cyst.

By location:

1. Arachnoid cyst of the Sylvian fissure 49% (the gap formed by the frontal and temporal lobes of the brain), sometimes called the arachnoid cyst of the temporal lobe.
2. Arachnoid cyst of the cerebellopontine angle 11%.
3. Arachnoid cyst of the craniovertebral junction 10% (junction between skull and spine).
4. Arachnoid cyst of the cerebellar vermis (retrocerebellar) 9%.
5. Arachnoid cyst sellar and parasellar 9%.
6. Arachnoid cyst of the interhemispheric fissure 5%.
7. Arachnoid cyst of the convexital surface of the cerebral hemispheres 4%.
8. Arachnoid cyst of the clivus area 3%.

Some retrocerebellar arachnoid cysts may mimic a Dandy-Walker anomaly, but there is no agenesis (a term meaning complete absence) of the cerebellar vermis and the cyst does not drain into the fourth ventricle of the brain.

Classification of arachnoid cysts of the Sylvian fissure.

Type 1: a small arachnoid cyst in the region of the pole of the temporal lobe, does not cause a mass effect, drains into the subarachnoid space.

2nd type: includes the proximal and middle sections of the Sylvian fissure, has an almost rectangular shape, partially drains into the subarachnoid space.

Type 3: includes the entire Sylvian fissure, with such a cyst, a bone protrusion is possible (external protrusion of the scales of the temporal bone), minimal drainage into the subarachnoid space, surgical treatment often does not lead to straightening of the brain (a transition to type 2 is possible).

Separate types of congenital arachnoid cysts.

It should be separately highlighted in this article such congenital cysts as a cyst of the transparent septum, a cyst of Verge and a cyst of the intermediate sail. It makes no sense to devote a separate article to each of the cysts, since you can’t write much about them.

Click on the picture to enlarge CT scan of the brain in the axial plane. The red arrow indicates a cyst of the transparent septum. By Hellerhoff [CC BY-SA 3.0 ], from Wikimedia Commons click image to enlarge MRI of the brain in the coronal plane. The red arrow indicates a cyst of the transparent septum. Author Hellerhoff [CC BY-SA 3.0 or GFDL], from Wikimedia Commons

A cyst of the transparent septum or a cavity of the transparent septum is a slit-like space between the sheets of the transparent septum, filled with fluid. It is a stage of normal development and does not last long after birth, so it is present in almost all premature babies. It is found in about 10% of adults and is a congenital asymptomatic developmental anomaly that does not require treatment. Sometimes it can communicate with the cavity of the third ventricle, so it is sometimes called the "fifth ventricle of the brain." The transparent septum belongs to the median structures of the brain and is located between the anterior horns of the lateral ventricles.

Verge's cyst or Verge's cavity is located immediately behind the cavity of the transparent septum and often communicates with it. Occurs very rarely.

The cyst or cavity of the intermediate sail is formed between the thalamus above the third ventricle as a result of the separation of the legs of the fornix, in other words, it is located in the midline structures of the brain above the third ventricle. It is present in 60% of children under 1 year of age and in 30% between 1 and 10 years of age. As a rule, it does not cause any changes in the clinical condition, however, a large cyst can lead to obstructive hydrocephalus. In most cases, no treatment is required.

Clinical signs of an arachnoid cyst.

Clinical manifestations of arachnoid cysts usually occur in early childhood. In adults, symptoms are much less common. They depend on the location of the arachnoid cyst. Often, cysts are asymptomatic, are an incidental finding during examination, and do not require treatment.

Typical clinical manifestations of an arachnoid cyst:

1. Cerebral symptoms due to increased intracranial pressure: headache, nausea, vomiting, drowsiness.
2. epileptic seizures.
3. Protrusion of the bones of the skull (it happens rarely, I have not personally encountered it yet).
4. Focal symptoms: monoparesis (weakness in the arm or leg), hemiparesis (weakness in the arm and leg on one side), sensitivity disorders according to mono- and hemitype, speech disorders in the form of sensory (lack of understanding of addressed speech), motor (inability to speak) or mixed (sensory-motor) aphasia, loss of visual fields, paresis of the cranial nerves.
5. Sudden deterioration, which may be accompanied by depression of consciousness up to coma:

• In connection with hemorrhage into the cyst;
• In connection with the rupture of the cyst.

Diagnosis of an arachnoid cyst.

Usually, neuroimaging is sufficient to diagnose an arachnoid cyst. These are computed tomography (CT) and magnetic resonance imaging (MRI).

Additional diagnostic methods are contrast studies of the CSF pathways, such as cisternography and ventriculography. They are required occasionally, for example, in the study of median suprasellar cysts and in lesions of the posterior cranial fossa for the purpose of differential diagnosis with Dandy-Walker anomaly.

Examination of the fundus by an ophthalmologist for hypertension syndrome (intracranial hypertension).

Electroencephalography (EEG) in case there was an epileptic seizure, to determine whether it was really caused by a cyst.

Treatment of an arachnoid cyst.

As I said above, most congenital arachnoid CSF cysts are asymptomatic and do not require any treatment. Sometimes a neurosurgeon may recommend dynamic monitoring of the size of the cyst, for which it will be necessary to periodically perform computed tomography or magnetic resonance imaging.

In rare cases, when an arachnoid cyst is accompanied by the above symptoms and has a mass effect, surgical treatment is resorted to.

In some cases, with a sharp deterioration, due to rupture of the arachnoid cyst or hemorrhage into it, surgical treatment is urgently resorted to.

There is no standard size for an arachnoid cyst. Indications for surgery are determined taking into account the location and symptoms of the arachnoid cyst, and not just its size. This can only be determined by a neurosurgeon during an internal examination.

Absolute indications for surgery:

1. intracranial hypertension syndrome due to arachnoid cyst or concomitant hydrocephalus;
2. development and progression of neurological deficits.

Relative indications for surgery:

1. large "asymptomatic arachnoid cysts" causing deformation of neighboring lobes of the brain;
2. progressive increase in cyst size;
3. cyst-induced deformation of the CSF pathways, leading to impaired CSF circulation.

Contraindications for surgery:

1. decompensated state of vital functions (unstable hemodynamics, breathing), terminal coma (coma III);
2. the presence of an active inflammatory process.

There are three possible options for the surgical treatment of arachnoid cysts. Your treating neurosurgeon chooses tactics, taking into account the size of the cyst, its location and your wishes. Not all arachnoid cysts are suitable for all three methods.

Evacuation of an arachnoid cyst through a burr hole in the skull using a navigation station. The advantage is the simplicity and speed of execution with minimal trauma to the patient. But there is a drawback - a high frequency of cyst recurrence.

An open operation, that is, a craniotomy (cutting out a bone flap on the skull, which fits into place at the end of the operation) with excision of the cyst walls and fenistration (drainage) of it into the basal cisterns (cerebrospinal fluid spaces at the base of the skull). This method has the advantage of being able to directly examine the cystic cavity, avoids a permanent shunt, and is more effective in treating multi-cavity arachnoid cysts.

Bypass surgery with the installation of a shunt from the cyst cavity into the abdominal cavity or superior vena cava near the right atrium through the common facial vein or internal jugular vein. Many foreign and domestic neurosurgeons consider shunting of an arachnoid cerebrospinal fluid cyst to be the best method of treatment, but it is not suitable in all cases. The advantage is low mortality and low recurrence rate of the cyst. The disadvantage is that the patient becomes dependent on the shunt, which is placed for life. If the shunt is blocked, it will need to be replaced.

Complications of the operation.

Early postoperative complications - liquorrhea, marginal necrosis of the skin flap with divergence of the surgical wound, meningitis and other infectious complications, hemorrhage into the cyst cavity.

Outcomes of treatment of an arachnoid cyst.

Even after a successful operation, part of the cyst may remain, the brain may not fully expand, and the midline structures of the brain may remain displaced. It is also possible to develop hydrocephalus. As for focal neurological symptoms in the form of paresis and other things, the longer it exists, the less likely it is to recover.

Literature:

1. Neurosurgery / Mark S. Greenberg; per. from English. - M.: MEDpress-inform, 2010. - 1008 p.: ill.
2. Practical Neurosurgery: A Guide for Physicians / Ed. B.V. Gaidar. - St. Petersburg: Hippocrates, 2002. - 648 p.
3. Neurosurgery / Ed. HE. Dreval. - T. 1. - M., 2012. - 592 p. (Manual for doctors). - T. 2. - 2013. - 864 p.
4. Ivakina N.I., Rostotskaya V.I., Ozerova V.I. et al. Classification of intracranial arachnoid cysts in children // Topical issues of military medicine. Alma-Ata, 1994. Part 1.
5. Mukhametzhanov X., Ivakina NI Congenital intracranial arachnoid cysts in children. Almaty: Gylym, 1995.
6. K.A. Samochernykh, V.A. Khachatryan, A.V. Kim, I.V. Ivanov Features of surgical tactics for large arachnoid cysts. \\ Scientific and practical journal "Creative Surgery and Oncology" Academy of Sciences of the Republic of Belarus Media Group "Health", Ufa, 2009
7. Huang Q, Wang D, Guo Y, Zhou X, Wang X, Li X. The diagnosis and neuroendoscopic treatment of noncommunicating intracranial arachnoid cysts. Surg Neurol 2007

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Usually, when it comes to any neoplasms in the human body, this causes considerable concern for the patient and his relatives. It is especially unpleasant if something like this is detected in a child. Involuntarily, people associate such a diagnosis with the terrible word oncology. However, do not forget that not all tumors are malignant. Let's try to figure out what type of neoplasm a brain cyst in a child belongs to and what such a diagnosis means for a small patient.

What is a brain cyst: symptoms and causes

Most often, such a diagnosis is made to the youngest patients. Sometimes a pathological formation is detected in a child even before birth. Often it is discovered during an ultrasound examination of the baby's head - neurosonography. Indications for ultrasound are a difficult pregnancy or difficult childbirth, hypoxia (lack of oxygen) of the fetus, prematurity, low assessment of the condition of the newborn on the Apgar scale (a system for assessing the condition of the newborn according to five criteria, set in the range from 0 to 10). Such an ultrasound allows you to see clear results, because it is carried out through an unextended fontanelle. If the diagnostician sees any problems in a small patient, then additional studies may be prescribed to detail the diagnosis.

What is a brain cyst? Doctors call it a neoplasm that has a spherical shape and is filled with liquid. As a rule, it occurs on the site of dead brain tissue. Sometimes specialists identify several of these neoplasms at once. Most often, congenital pathologies of the development of the nervous system or injuries of the postpartum period lead to their appearance. The cyst is usually not dangerous, but it can grow and at the same time put pressure on neighboring parts of the brain, thus provoking poor health of the child, delays in growth and development.

The symptoms of this disease depend on the size of the neoplasm and its location in the brain. Small formations do not have any symptoms. Large ones can lead to headaches, vision problems, dizziness, impaired coordination of movements, convulsions, hearing impairment, nausea, vomiting, increased drowsiness, and so on.

Is a brain cyst dangerous: consequences

The degree of danger depends on the type of formation.

The most common in children is a choroid plexus cyst. The choroid plexuses produce cerebrospinal fluid that nourishes the brain. If the child's brain develops too quickly, then the free space between the choroid plexuses is filled with this fluid. This is how a vascular plexus cyst occurs. Such formations, as a rule, do not affect the brain and its work. Often they are detected during an ultrasound of the fetus while still in the womb. Most of them disappear before birth. If a similar diagnosis is made to a newborn, then it is usually associated with a herpes infectiontransferred by the mother during childbearing.

Usually such cysts resolve themselves during the first year of a baby's life. Therefore, with this diagnosis, the child is regularly examined by a neurologist, after three months an ultrasound scan is performed to monitor the state of education. If after a year it does not disappear, then the doctor prescribes additional studies and treatment.

A subependymal cyst occurs in the brain of a newborn child as a result of a birth injury or may be caused by prolonged oxygen starvation. This variety is considered a pathology, although most often it does not grow and does not affect the health of the baby, but requires constant monitoring and medical supervision. True, there are cases when a too large subependymal cyst exerted pressure on the brain tissue and, thus, provoked a deterioration in the child's well-being.

The most dangerous type is the arachnoid cyst of the brain in children. It is detected in three percent of the examined newborns, more often in male infants. This type of ailment is congenital or may result from inflammation or injury. It is formed between the surface of the brain and the arachnoid. Such a formation can rapidly increase and, as a result, compress the brain tissue. Symptoms such as nausea, vomiting, convulsions, tremors of the arms and legs may indicate its presence.

How to treat a brain cyst in children

In most cases of the development of this pathology in children, no treatment is required. According to medical statistics, most of these neoplasms either dissolve over time, or, without changing their original size, do not affect the state and development of the brain.

In cases where a child has been diagnosed with a subependymal or vascular plexus cyst, no special treatment is prescribed. Such a patient is under the supervision of a specialist and regularly undergoes special studies (the doctor monitors the state of the formation, its size).

When an arachnoid cyst is detected, treatment is prescribed, usually surgical, since this type of neoplasm does not resolve, but, on the contrary, has a tendency to rapid growth.

Removal of a brain cyst in a child

Patients with an arachnoid type of formations may be scheduled for surgery to remove. When using radical techniques, the cyst is removed along with its contents.

In addition, such patients are often prescribed palliative surgical treatment. It is more gentle than radical, and provides for the removal of not the cyst itself, but only its filling. Here, endoscopy or bypass surgery is used. During the last procedure, fluid is removed from the cyst using a special shunt system. The disadvantage of this method is the high risk of infection of the brain due to the long stay of the shunt in it.

During an endoscopy, the doctor makes small punctures and through them removes fluid from the cyst. This manipulation is less traumatic.

Especially for - Ksenia Boyko

… a cyst is not a tumor…

The arachnoid cyst of the brain, which is the most common type of brain cyst, present in 4% of the population, is a sac filled with liquor (cerebrospinal or cerebrospinal fluid) located in the arachnoid membrane of the brain. At the site of the cyst, the tissue of the arachnoid membrane is divided into two layers with the accumulation of fluid between them.

It is important to remember that a cyst is not a tumor and in most cases is either asymptomatic or mild and very rarely requires surgery.

By origin, arachnoid cysts can be divided into:

• Primary, formed during fetal development;
• Secondary, arising, arising as a result of injury or trauma, inflammatory processes occurring in the brain or bleeding.

According to the dynamics of development, there are cysts:

• Progressive. This type of cyst is characterized by a gradual increase in symptoms associated with the fact that the cyst increasing in volume increases its pressure on the brain.
• Frozen. These formations are stable and usually do not cause concern, often occur without symptoms, and some are detected only incidentally during brain imaging due to other reasons.

Symptoms of an arachnoid cyst

Depending on the location and size of the cyst, one or more symptoms may appear:

• Headache;
• Nausea and vomiting;
• Lethargy, including excessive fatigue or lack of energy;
• Seizures;
• developmental delays;
• Hydrocephalus caused by a violation of the natural circulation of the cerebrospinal fluid;
• Problems with the endocrine system, for example, earlier onset of puberty;
• Involuntary shaking of the head;
• Vision problems.

The larger the cyst, the more symptoms will appear, their frequency and strength will increase. With prolonged and strong compression, it can lead to irreversible changes in brain tissue. With excessive compression and rupture of the cyst membranes, the death of the patient is possible.

Diagnosis and treatment of an arachnoid cyst

Cysts that flow without any manifestations can only be detected by chance. In the case of neurological manifestations, the doctor first of all analyzes the patient's complaints. However, manifestations can only indicate that there are some malfunctions in the brain, but do not allow classifying the problem. Hematomas, brain tumors, cysts located inside the brain have the same symptoms. For a more accurate diagnosis, the doctor may prescribe electroencephalography, echoencephalography or rheoencephalography. The disadvantage of these methods is that they do not provide information about the exact location of the formation, nor about its nature.

The main goal of any treatment for an arachnoid cyst is to drain fluid and reduce pressure on the brain tissue.

To date, the most accurate diagnostic method that allows a high degree of accuracy to distinguish an arachnoid cyst from a tumor or hematoma is computed tomography (CT) and magnetic resonance imaging (MRI).

This can be achieved by various methods, including:

• Shunting. In this method, the surgeon inserts a tube (shunt) into the cyst through which fluid is diverted to other parts of the body (for example, the abdominal cavity), where it is absorbed by other tissues.
• Fenestration. In this case, holes are created in the patient's skull and cyst walls for drainage and ensuring the normal flow of cerebrospinal fluid.
• Needle aspiration and connection through holes of the inside of the cyst with the subarachnoid space to drain fluid into it.

MRI diagnostics for arachnoid cyst

Although CT can accurately determine the size and location of the cyst, MRI provides the most accurate and complete information about the formation. Usually, to diagnose an arachnoid cyst, an MRI scan is performed with the introduction of contrast into the patient's bloodstream. At the same time, brain tumors tend to accumulate contrast, and cysts do not absorb it from blood vessels, which is very clearly seen on MRI.

It also allows you to distinguish a cyst from hemorrhages, hematomas, hygromas, abscesses and other diseases with similar symptoms. In addition, MRI makes it possible to detect a cyst even in cases where the patient does not yet have any manifestations, and the cyst itself is only a few millimeters in size.

Second opinion for arachnoid cyst

Despite the fact that MRI diagnostics using a contrast agent provides the doctor with the necessary information, the risk of error still exists. It is associated primarily with the doctor's lack of residual experience in interpreting MRI results and identifying cysts. Not a single patient is immune from such errors, and they happen both in large cities and in small towns. In this situation, the only way to eliminate an error or at least reduce its probability by several times is to get a second opinion from a highly qualified specialist.

The National Teleradiological Network (NTRS) offers you the opportunity to get advice from the country's leading specialists in the field of MRI diagnostics, who have extensive experience in analyzing tomographic images of various diseases. To get a consultation, you just need to upload the scan results to our server and in a day you will receive an opinion that is alternative to the opinion of your doctor.

Perhaps it will be the same as the first medical opinion, it may be different from it, but the second opinion will definitely allow you to reduce the risk of misdiagnosis and improper treatment to almost zero.

The arachnoid cyst of the brain is a neoplasm of a benign nature, which has the shape of a bubble and is located between the membranes of the brain. These cysts are filled with cerebrospinal fluid.

Typically, a person is not aware of the presence of a cyst until they have an MRI of the brain, since such formations rarely give any symptoms. The first complaints appear in the patient when the cysts reach an impressive size. At the same time, they begin to put pressure on the brain tissue, a person has increased intracranial pressure, which gives characteristic symptoms. Treatment is surgical: the cyst is drained, excised, or shunted.

An arachnoid cyst is a neoplasm bounded by an arachnoid or collagen sheath. Inside it accumulates cerebrospinal fluid, which is called cerebrospinal fluid. 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 is formed, the arachnoid membrane of the brain is thickened and has a duplication, that is, it is divided into 2 sheets. It is between them that liquor can begin to accumulate.

Cysts are most often small, although they may swell when filled with cerebrospinal fluid. Such bubbles put pressure on the cerebral cortex and cause the corresponding symptoms.

The site of cyst formation may vary. Its favorite localization is the cerebellopontine angle, the Sylvian sulcus, or the area above the Turkish saddle. As practice shows, about 4% of the population are carriers of such cysts, but most people do not know about their existence, since there are simply no symptoms. Most 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 traumatic brain injuries, which occur much less frequently in women. Arachnoid cysts account for about 1% of all brain tumors.

Depending on the origin of cysts, primary and secondary tumors are distinguished. Primary cysts are pathological neoplasms of the brain that are obtained by a person from birth, for example, Blake's pouch cyst. Congenital cysts are malformations of intrauterine development, since the nervous 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 fibers predominate in the composition of such cysts.

Depending on the structure of the cyst, complex and simple neoplasms are distinguished. Simple cysts are represented by a poutine membrane, they 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, there are 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 increase in size. 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 is formed within the cranium, there are retrocerebellar cysts. They form 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 cysts most often do not give themselves away with any symptoms. This is true for small neoplasms. In the vast majority of cases, congenital cysts are discovered by chance, during neurosonography through a fontanel that has not closed in a child. Or they can be diagnosed during an MRI for another pathology. When an infection that affects the brain enters the body, the cyst can make itself felt. Provoke its growth, which means symptoms, can be trauma to the brain, as well as damage and vascular disease.

If the volume of cerebrospinal fluid located in the cavity of the cyst begins to increase, this provokes its growth. At the same time, symptoms indicating an increase in intracranial pressure manifest. Depending on the location of the neoplasm, the patient will begin to be disturbed by the corresponding neurological symptoms. Signs of the presence of a cyst will be experienced by one in five of its owners.

These include:

Specific headache in the bones of the skull - carnialgia.

Sensation of pulsation in the head.

Gait disturbance.

A spinal cyst can give symptoms that resemble a clinic for a herniated disc.

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

Pain in the area of ​​the eyeballs.

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

Immobilization of one half of the body, a decrease in muscle strength from paresis are severe manifestations of an arachnoid cyst that occur only in advanced cases. Episodes of loss of consciousness and convulsive seizures are also characteristic of 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 a risk of death due to rupture of the cystic cavity.

In addition, a cyst that compresses the brain structures for a long period of time 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:

Arachnoid cyst, located in the temples, manifests itself as symptoms of increased blood pressure, convulsions, impaired sensitivity and motor activity on the side opposite to the location of the tumor. Temporal arachnoid cyst is manifested by 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 clamping the brain stem. As a result, the patient may experience respiratory and cardiac disorders, paralysis and paresis, coordination deteriorates, and nystagmus develops. When the tumor becomes large, the risk of coma and death from compression of the stem structures increases.

When the cerebellum is clamped in a person, coordination disorders are observed first of all, gait suffers. Involuntary movements may appear, bouts of dizziness occur, nausea and noise in the head are disturbing.

If a cyst is formed during fetal development, then this is due to the influence of pathogenic factors on the fetus.

These include:

Intrauterine infections: toxoplasmosis, herpes, rubella virus, etc.

Postponed surgical interventions on the brain.

Infections transferred during life: inflammation of the brain, arachnoiditis and meningoencephalitis.

Postponed intracerebral hemorrhages.

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

An examination by a neurologist makes it possible 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 certain neurological symptoms.

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

• MRI or CT are the most informative 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.

If the arachnoid cyst does not grow and 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 monitor the growth and development of the cyst, if any.

When the cyst progresses and causes neurological symptoms, it needs to be treated. Drug correction is reduced to taking drugs that normalize cerebral circulation (nootropics, vasotropes, antioxidants). Sometimes the patient is prescribed drugs that allow the adhesions to dissolve (Karipain, Longidase). The help of a surgeon is needed in the case when taking medications does not solve the problem.

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

Shunting. 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 with the cerebral ventricle or 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 on the condition that other methods of treatment are ineffective. With a hemorrhage in the area of ​​​​the cyst, or with its rupture, the 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.

The prognosis depends on how the brain cyst manifests itself. For many years or even throughout her life, she may not give herself away in any way. If the cyst progresses, then the prognosis worsens. Sometimes such neoplasms cause a person to become disabled, or even die. However, this situation is observed only in advanced cases. If the surgeon's help was timely, then the person recovers completely. However, it is impossible to exclude the risk of its recurrence.

As for preventive measures, they can be as follows:

Take care of your health during pregnancy.

Careful pregnancy planning.

Timely treatment of injuries, inflammation and vascular pathologies of the brain.

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

Education: In 2005, she completed an internship at the First Moscow State Medical University named after I.M. Sechenov and received a diploma in Neurology. In 2009, she completed her postgraduate studies in the specialty "Nervous Diseases".

Arachnoid cyst (syn. CSF cyst) is a neoplasm with a benign course localized either in the brain or in the cavity of the spinal canal. A person can get sick at any age.

One of the main factors in the formation of pathology is burdened heredity. The cause may be frequent injuries of the skull or spinal column, extensive internal hemorrhages, a sedentary or, conversely, an overly active lifestyle.

Many factors affect the severity of symptoms, but the size of the tumor is most important. The main clinical signs are considered to be pain, paresis of the lower and upper extremities, and a change in gait.

Only a neurologist, who takes the results of instrumental examinations as a basis, can establish the final diagnosis. Ancillary diagnostic measures are laboratory tests and manipulations performed directly by the clinician.

Treatment of pathology in adults and children is carried out only by surgical intervention. However, for small volumes of cystic mass, clinicians use conservative methods of treatment.

In the international classification of diseases, the problem is assigned several meanings that differ in the location of the neoplasm. For example, the arachnoid cyst of the brain has the ICD-10 code G93.0, and the arachnoid cyst of the spine has the code D32.1.

Etiology

A neoplasm filled with cerebrospinal fluid (CSF) is included in the group of rare pathological processes, since only 5% of people on Earth live with such a diagnosis.

In most situations, the causes of the disease are represented by such factors:

• intrauterine anomalies in the development of the fetus;
• the course of the inflammatory process in the brain in the Sylvian fissure;
• any conditions leading to increased intracranial pressure;
• frequent head injuries;
• transferred and other cardiovascular pathologies;
• performed medical intervention on the brain;
• bleeding in the brain, especially extensive;
• the course of infections that adversely affect the functioning of the central nervous system;
• many years of unhealthy lifestyle;
• long-term impact on the human body of adverse environmental conditions;
• complicated course of gestation or labor activity - most often leads to the development of the disease in children;
• oxygen starvation of brain tissues;
• degenerative changes in the brain.

Arachnoid cyst of the posterior cranial fossa or other area of ​​the brain is characterized by a slow increase in size. However, there are several negative factors that can provoke the growth of a neoplasm:

• diseases of an autoimmune nature;
• chronic heart disease;
• subdural hematomas;
• neuroinfections.

An arachnoid cyst of the spinal cord or spine often results from such processes:

Education is secondary, but practically not prone to malignancy. It should be borne in mind that clinicians do not exclude the possibility of the influence of a genetic predisposition.

Classification

Based on the etiological factor, the arachnoid cyst of the brain, lumbar and other areas of the spine is:

• congenital - refers to malformations of the brain or spinal cord;
• acquired - a consequence of the influence of one of the unfavorable provocateurs.

The division according to the morphological structure of the wall of the cystic formation suggests the existence of such types of foci:

• a simple or true tumor - the cavity of a pathological neoplasm is lined with arachnoid membranes that can produce cerebrospinal fluid (CSF);
• a complex or false tumor - the lining is made up of other tissues.

According to clinical signs, a neoplasm with localization in the head or spine can be:

• progressive - there is an increase in the volume of the cyst, which provokes a vivid manifestation of symptoms;
• frozen - does not increase in size and often has an asymptomatic course.

Tumors of the spinal column are divided into several types:

• perineural arachnoid cyst (has a congenital character) - occurs in 7% of cases;
• periarticular cyst - is formed in the area of ​​the facet joints;
• aneurysmal cyst - localized inside the bone and filled with venous blood;
• retrocerebral cyst - a cavity that is filled with cerebrospinal fluid.

According to the focus of the pathological process, there are:

• arachnoid cyst of the sacral spine;
• damage to the cervical, thoracic and lumbar segments.

Brain damage has its own forms, which is why clinicians define the following types of disease:

• arachnoid cyst of the left temporal lobe - occurs several times more often than the lesion of the right temporal lobe;
• cyst of the posterior cranial fossa;
• arachnoid cyst of the cerebellum or cerebellar angle;
• parietal cyst;
• sylvian fissure cyst;
• cyst of the Turkish saddle;
• convexital cyst;
• arachnoid cerebrospinal fluid cyst.

Symptoms

The degree of severity of clinical signs is influenced by the volume of the neoplasm. In some cases, symptoms may be completely absent, but this happens only with the development of a frozen cyst. The correct diagnosis in such cases is made by chance - pathology acts as a diagnostic discovery.

The arachnoid cyst of the temporal lobe on the left or right, as well as the localization of the tumor in other parts of the brain, has the following symptoms:

• severe headaches;
• constant nausea without vomiting;
• paralysis and paresis of the arms or legs;
• hearing loss;
• change in gait;
• problems with maintaining balance;
• decreased visual acuity;
• loss of sensation in the skin of the extremities;
• disorientation in time and space;
• insomnia;
• pulsation in the temporal region;
• rapid fatigue and decreased performance;
• attention disorder;
• deterioration of thinking;
• bouts of dizziness;
• frequent mood swings;
• fainting states;
• hallucinations.

Damage to the spinal column is expressed by such signs:

• sharp or dull pain in the damaged spine;
• dizziness and;
• tingling and numbness of the skin of the hands and feet;
• problems with emptying the intestines and bladder;
• lameness;
• back;
• muscle weakness and paresis of the limbs;
• fluctuations in blood tone;
• problems with swallowing food;
• and nausea;
• disability

An arachnoid tumor of the spine or a brain cyst in a child is represented by the following symptoms:

• weakness and fatigue;
• lethargy of the upper and lower extremities;
• pulsation and swelling of the fontanel;
• sleep disturbance;
• increased tearfulness;
• frequent regurgitation;
• constant anxiety;
• gaze disorientation;
• change in the size of the head - the age norm can be exceeded several times;
• seizures;
• hearing loss.

The clinical picture will always have an individual character.

Diagnostics

To make a correct diagnosis, it is necessary to carry out a number of instrumental examinations, but such procedures must necessarily be preceded by primary diagnostic manipulations performed directly by a neurologist:

• familiarization with the medical history of both the patient and his relatives - to identify the etiological factor with a pathological or genetic basis;
• analysis of the anamnesis of life;
• collection of information about the period of bearing a child;
• a thorough physical and neurological examination;
• determination of hearing and vision acuity;
• measurement of head volumes and blood pressure indicators;
• a detailed survey of the patient or his parents - to compile a complete clinical picture of the course of the anomaly.

An arachnoid cyst of the brain or any part of the spine can only be detected using the following instrumental procedures:

• CT and MRI of the spine;
• Doppler scanning of the vessels of the back of the head;
• ECG and echocardiography;
• daily monitoring of blood pressure;
• radiography with the use of a contrast agent;
• Ultrasound and CT of the brain;
• electroencephalography;
• echoencephalography;
• rheoencephalography;
• angiography of vessels with the use of a contrast agent.

Laboratory diagnostic measures are of secondary importance: only general clinical and biochemical blood tests are prescribed.

Treatment

Treatment is carried out using surgical techniques. However, the use of conservative methods of therapy is indicated for small neoplasms.

Conservative therapy:

• bed rest;
• injection of painkillers and anti-inflammatory drugs;
• the use of funds to improve blood microcirculation;
• the use of analgesic blockades;
• balanced nutrition - the menu should contain a sufficient amount of vitamins, proteins and useful trace elements;
• physiotherapeutic procedures, for example, drug phonophoresis, ultrasound, acupuncture and laser therapy;
• course of therapeutic massage;
• wearing special corsets and bandages - only necessary if the back is damaged;

As for surgical intervention, treatment is carried out by such methods:

• neurosurgical operation;
• shunting of the brain;
• endoscopic procedures on the skull or spinal column;
• laser excision of education.

After surgery, patients need long-term rehabilitation.

Possible Complications

The formation of an arachnoid cyst is fraught with the development of such complications:

• increase in neoplasm in size;
• convulsive seizures;
• chronic headaches;
• rupture of pathogenesis with subsequent blood poisoning;
• lagging behind children in physical and mental development;
• extensive internal bleeding;
• disability.

Prevention and prognosis

To prevent an arachnoid tumor of the spine or a brain cyst in newborns, general preventive measures must be observed, since specific recommendations have not been developed to date.