Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Sub-Arachnoid Cyst

Forum: Neurology Forum
Topic: Arachnoiditis


I am a 28 year old female who was diagnosed with a sub arachnoid cyst 4 years ago. At that time I underwent a fenestration surgery at the University of Miami, Jackson Hospital. Two weeks after my surgey and after a seemingly quick recovery I had a hemmorage at the surgery site. After spending 3 weeks in two different hospitals and undergoing a series of lumbar puntures (1 a day for 8 days) (my csf pressure at first reading was 420) I have to come to find out that not only has the cyst returned but is now larger than before. The cyst has mass effect and is causing compression of the brain, as well as having empty sella syndrome. The cyst itself is located on my brainstem. I am refusing (at this time) any further surgical options because of my past experience. The only thing the dr.s recommend is a shunt. Is there any other type of procedure that might be beneficial? My symptoms are not as severe as before the surgery, but they include headaches, dizziness, vomiting, slurred speech and vision disturbances. Iam a single, working mom of a very active 6 year old and the thought of undergoing another major surgery with alot of recovery time is not an option for me. Do you have any suggestions? Thank you for your help.


Dear Trina:

The main treatment modalities of arachnoid cysts are fenetrations and
shunting. Obviously there are complications associated with both. There
are no medical therapies that are known to be of value in treating these
problems. I would recommend that you have a shint placed. This procedure
is well established. the risk is fairly minimal but as you may or may not
know, shunts (or any foreign body that is implanted in human tissue) may
be at risk for infection. Fortunately that is not very significant.
I wish there were other options but I am afraid that with your current
symptoms you will need to have something done or you may have worsening
symptoms.

Good Luck!



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