|ICD-10||Q 04.6 04.6|
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Arachnoid cyst - CSF cyst, the walls of which are formed by cells of the arachnoid or cicatricial collagen. Arachnoid cysts are located between the surface of the brain and the arachnoid (arachnoid) membrane.
Primary (true) arachnoid cysts - congenital formations. Secondary ones occur after suffering meningitis, surgery, with Marfan syndrome, corpus callosum agenesis, etc., with secondary arachnoid cysts, the wall is an arachnoid scar. Arachnoid cysts are four times more common in men than in women, and are usually localized within the rich arachnoid shells of liquor tanks, expanding them. More often arachnoid cysts are formed in the middle cranial fossa, outside the temporal lobes of the brain.
Arachnoid cysts result from the formation of congenital duplicature of the arachnoid membrane, followed by filling it with spinal fluid. The walls of the cyst consist of flat glial cells (meningothelium) forming a translucent membrane. Solid component and epithelial lining are absent.
Symptomatology Symptoms of arachnoid retrocerebellar cyst
In most cases, brain cysts (arachnoid, retrocerebellar cysts) are asymptomatic. These tumors are detected during the next examination of the patient or in the diagnosis of neurological diseases of similar symptoms. Symptoms of arachnoid cysts are non-specific. The severity of symptoms of arachnoid, retrocerebellar cyst depends on the location and size of the formation. Most patients have cerebral symptoms associated with squeezing certain areas of the brain. It is rarely observed focal symptoms due to the formation of hygroma, rupture of arachnoid cyst.
The main symptoms of arachnoid, retrocerebellar cyst:
- Dizziness, not caused by other factors (fatigue, anemia, medication, pregnancy in women),
- Nausea, vomiting, not caused by other factors (medication, poisoning, other diseases),
- Hallucinations, mental disorders,
- Loss of consciousness,
- Feelings of numbness in the limbs, hemiparesis,
- Headaches, poor coordination,
- A feeling of pulsation, headache,
- Impaired hearing, vision,
- Clear recognition of tinnitus while preserving hearing
- Heaviness in the head,
- Strengthening pain when moving his head.
It should be noted that in a secondary type of arachnoid cyst, the clinical picture may be supplemented by symptoms of the underlying disease or injury, which is the primary cause of the formation of the cystic cavity.
Diagnosis of arachnoid liquor cyst
Various methods are used to diagnose arachnoid liquor cyst (cyst filled with cerebrospinal fluid). The main among them are magnetic resonance imaging and computed tomography to detect cystic formation, determine its location, size. Intravenous administration of contrast allows differentiation of the arachnoid liquor cyst from the tumor (the tumor accumulates contrast, there is no cyst).
It should be remembered that the arachnoid cyst is often the result of another neurological disease or impaired functioning of any organ systems. To identify the root causes of arachnoid cysts, the following diagnostic methods are used:
- Blood tests to detect viruses, infections, autoimmune diseases,
- Blood tests for clotting and cholesterol levels,
- Doppler study allows to detect the violation of vascular permeability, as a result of which a lack of cerebral blood supply develops,
- Blood pressure monitoring that records pressure fluctuations per day,
- Heart studies.
Accurate identification of the causes of the development of arachnoid cysts allows you to choose the best ways to treat cystic formation and minimize the risk of recurrence.
Treatment of arachnoid cyst
According to the dynamics of the development of arachnoid cysts distinguished frozen cystic formations and progressive cysts. As a rule, the frozen formations do not cause the patient painful sensations, do not represent a risk for normal brain activity. In this case, the treatment of arachnoid cysts is not required. In cases of frozen cysts, diagnosis and treatment are aimed at identifying the root causes of cyst formation, as well as the elimination and prevention of factors contributing to the formation of new cysts.
With a progressive type of cystic formations, the treatment of arachnoid cyst involves a set of measures aimed at identifying and eliminating the causes of the cyst, as well as the immediate removal of the cyst itself.
Drug treatment of arachnoid cysts is aimed at eliminating inflammatory processes, normalizing cerebral blood supply, restoring damaged brain cells.
With the ineffectiveness or low effectiveness of conservative methods of treatment of arachnoid cyst, radical methods are used. Indications for surgery are:
- Risk of rupture of arachnoid cysts,
- Violations of the patient’s mental state with frequent convulsive and epileptic seizures,
- Increased intracranial pressure
- Strengthening focal symptoms.
The main methods of surgical treatment of arachnoid cysts are:
- Drainage - removal of fluid from the cavity by needle aspiration,
- Shunting - creating drainage for the outflow of fluid,
- Fenestration - excision of the cyst.
Syndrome of increased intracranial pressure is characteristic of any brain cyst. His signs are:
- bursting headache, dizziness,
- urging to vomit,
- ear noise, reduced accuracy,
- a feeling of pulsation in the temples
- inaccurate walking
- emotional lability, tearfulness, short temper, sleep disturbance.
When the disease progresses and increases in diameter, the symptoms are more pronounced. So, the headache becomes chronic, aggravated by changing the position of the head. Hearing is reduced, diplopia occurs (doubling of the image in the eyes), before the eyes, with a sudden change in the position of the body, the flies appear, in the eyes themselves darken.
The deficit neurological symptoms develop. The speech is upset: the patients speak indistinctly, the words and sounds are slurred, it is difficult for others to understand their conversation. The coordination sphere is upset, the gait is disturbed. Muscle strength is weakened, often by the type of hemiparesis (decrease in the strength of skeletal muscles on the arm and leg on one side of the body). Possible loss of the sensitive sphere on hemitip. Consciousness is often frustrated: syncope is observed (short-term loss of consciousness). The clinical picture is also complemented by convulsive seizures and mental disorders by the type of elementary visual or auditory hallucinations.
If the cyst is congenital, the child develops more slowly. He has signs of delayed psychomotor development. He later begins to sit, later takes the first steps and pronounce the first letters. School success is reduced compared to the average for other children.
Symptoms also depend on the localization of the volumetric process:
- Arachnoid cyst of the left temporal lobe. Accompanied by impaired hearing and speech. Often patients do not understand oral speech, but the possibility remains to form their own sentences.
- Arachnoid cyst of vChA. Located in the posterior cranial fossa, a cyst can squeeze and damage the cerebellum. Arachnoid cyst of the cerebellum will lead to impaired coordination and walking.
- Symptoms of arachnoid liquor cyst of the left lateral cleft of the brain are usually scarce. A typical manifestation is a syndrome of increased intracranial pressure. However, the arachnoid cyst of the lateral fissure of the brain on the left may be manifested by convulsions or impaired swallowing.
- Arachnoid cyst of the large cistern of the brain is manifested by a typical hypertensive syndrome.
What makes a cyst in the head
A benign globular formation - a cyst in the brain - inside is filled with cerebrospinal fluid. The severity of symptoms depends on the size of the neoplasm, but it is detected by random medical examination or by diagnosing any other disease. In most cases, arachnoid cyst of the brain is asymptomatic. Bright neurological symptoms are present only in 20% of cases. Factors affecting the appearance and growth of cysts:
- any brain injury
- growth inside cystic fluid pressure
- inflammatory process in the brain (infection, virus).
Types of arachnoid cyst
Leading experts in the field of medicine today determine two types of tumors, differing from each other by the cause. The first is the primary one, which develops the baby in the womb. Secondary is manifested in the process of the above pathologies. Also, the cyst can be simple, formed from the cerebrospinal fluid, and complex, having in its composition various types of tissues. According to the location of the tumor in the brain is divided into:
- left or right temporal lobe,
- parietal or frontal part of the head,
- spinal canal,
- posterior cranial fossa,
- spine (perineural),
- lumbar region.
It may be formed due to inflammatory processes that developed during the prenatal period. The cause of the appearance of a neoplasm is sometimes a birth trauma, a disease of meningitis in a newborn. Numerous violations of fetal development due to smoking, medication, drinking alcohol by a pregnant woman are frequent. If the primary cyst progresses rapidly, then with severe symptoms it can be removed at any age of the child.
This type of arachnoid cyst of the brain develops after suffering diseases, injuries, and surgical interventions. Occurrence can provoke a strong blow to the head, concussion of the brain after an accident, subarachnoid hemorrhage or mechanical damage. When a secondary cyst begins to form due to any pathology, its walls consist of scar tissue. If a cyst in an adult's brain has developed for another reason, then its walls contain tissues of the arachnoid membrane.
What is dangerous retrocerebellar arachnoid cyst
This type of neoplasm is located between the soft and hard shell of the brain. The risk factor is that the retrocerebellar arachnoid cyst can subsequently contribute to cell death, and this condition leads to the appearance of a malignant tumor. In children, the neoplasm leads to developmental delay or hypermobility syndrome. In adults, a growing cyst increases pressure on the gray matter and brain tissue.
Main signs and symptoms of education
Symptoms of a cyst appear with its growth. Headaches begin, tinnitus disturbed skin sensitivity. If the arachnoid cyst of the brain is not treated, then paralysis of the limbs may occur, epileptic seizures may appear, deafness may increase and vision may be lost. Symptomatology of the disease is characteristic of a specific area of the lesion.
Small bubbles with liquid contents in the brain tissues do not pose a threat to a person, and he lives with them easily all his life. Large education progressive type have clear signs of pathology. It:
- loss of orientation
- regular migraine,
- loss of sleep
- violation of muscle tone,
- nausea, vomiting,
- twitching limbs (involuntary),
When a cyst forms in newborns as a result of inflammation, damage or other brain pathology, this is a ramolation formation that occurs in any place. If a baby has parasites, for example, a tapeworm, then a parasitic cyst can develop. Cerebral neoplasms are a consequence of impaired circulation of interstitial fluid. Symptoms depend on the location and type of cyst, but there is no universal list. The following conditions may indicate a brain pathology in a child:
- pulsating spring,
- lethargy of the limbs
- disoriented look,
- regurgitation of the fountain after feeding.
The optimal diagnostic method of pathology is MRI of the brain. If there is a cyst, the final description of the tomography results will indicate: “arachnoidal changes in the liquorocistosis character”. Place of localization of education reveals the use of contrast agents. The main property of a neoplasm, in contrast to a tumor, is the ability to accumulate contrast. Laboratory tests and research are conducted as needed:
- blood for cholesterol
- to detect infections
- vascular Doppler,
- blood pressure measurement (reveals his jumps).
Methods of treatment of the disease will depend on the results of diagnosis. If the arachnoid cyst of the brain is small in size, it does not pose a health hazard. The patient will be monitored by a doctor and periodically examined. During this period it is important to eliminate the cause of the pathology and minimize the influence of negative factors. If the neoplasm grows rapidly, then medical therapy or surgery will be applied.
Medium sized cysts can be removed with medication. The course of treatment is prescribed individually and is carried out under the supervision of a physician until the patient's condition improves. Names of drugs that can stop the growth of tumors:
- resolving adhesions: Longidase, Caripatin,
- metabolic processes activating in tissues: Actovegin, Gliatilin,
- immunomodulators: Viferon, Timogen,
- antiviral: Pyrogenal, Amixin.
Folk remedies and herbs
With an asymptomatic brain cyst, it is possible to maintain the body with popular recipes:
- Tincture of the herb hemlock. Eliminates headaches. The duration of treatment is 79 days. If necessary, the course is allowed to repeat. You can prepare the tincture as follows: 100 g of seeds or crushed stems are poured with olive oil (0.5 l). For three weeks the solution should be left in a dark place. After the oil is passed through the gauze several times. The infusion is taken through the nose 3 times / day, 2 drops.
- Infusion from the root of the Caucasian Dioscorea. Favorably affects the work of the brain: cleans and dilates blood vessels. The course of reception is 2-3 months. The root (200 g) is crushed, the jar is filled, poured 700 ml of vodka. In a cool place, the composition is infused for 5 days. After the infusion is drained, another 700 ml of vodka are poured. After 5 days, both compositions are mixed, filtered and used in 2 tsp. three times a day before meals.
- Elixir from yeast. Helps reduce inflammation, normalization of intracranial pressure. The course of treatment is three weeks. Yeast (1 tbsp.) Is mixed with dried herb elecampane (40 g) and three liters of boiled water.Insist 2 days, then take 4 times / day for half a cup.
If the brain cyst increases in size, then an operation will be assigned to remove it. Modern medicine involves several types of surgery:
- the endoscopic method is the least traumatic when the contents are removed through the punctures,
- shunting in surgery is carried out by introducing a drainage tube into the cyst cavity (the risk of infection is high),
- fenestration is performed by excision of the formation using a laser,
- puncture, which involves the removal of the capsule using a superfine instrument (high probability of neurological complications),
- craniotomy - the most radical and effective operation, combined with increased trauma.
Forecasts and consequences
With timely detection of cerebral cysts forecasts are favorable. The main risks with which arachnoid formation is associated are squeezing of the brain centers, after which disruptions occur in the body. After removal of a cyst, speech, hearing or vision impairment is sometimes observed. In case of late diagnosis, cyst rupture, hydrocephalus, and death are possible.
Resizing arachnoid cysts should not be taken as an oncologic disease, but preventive measures should be taken to maintain brain health. These include: adherence to physical activity, proper nutrition, giving up bad habits. People after 40 years every six months, it is advisable to visit a cardiologist and a neurologist for examination.