Arachniod Cyst

[Terry L.]

My wife is seven months pregnant.  During a routine ultrasound, doctors found what was described by the OB/GYN as a “cyst in the brain”.  Upon being referred to another doctor at a perinatal clinic for high risk pregnancy, another ultrasound was done and a preliminary diagnoses was given.  The doctor said the cyst appears to be an arachnoid cyst measuring 20 mm X 15 mm in the area of the left posterior left hemisphere.  It also appeared “that the posterior hemisphere may be getting compressed laterally by the cystic structure”.  We have not been able to get an appointment with a pediatric neurologist yet (some have up to a year wait), and the other doctors seem hesitant to speculate on what effects this may have on our baby, if the baby is in pain due to the compression, if there will be intellectual limitations of the child, will surgery be a possibility after birth, do the cysts usually grow or decrease/disappear in size, etc.  It should be noted that everything else with the baby is fine -- normal size, excellent activity, normal amniocentesis, “Doppler shows normal blood flow in the Circle of William and no flow of blood within the cyst”.  Any information you could  give us would be great, it’s agonizing for a parent-to-be to be told there is some kind of brain abnormality in their child and not really know what can be done or the future effects it may have on the baby.
Thank you!

[CCF Neuro[P] MD, RPS]

Dear Terry:

I am sorry o hear about your daughter.  You will know alot more as you follow the archnoid cyst over the rest of your pregnancy.  Most of the time, such a cyst is an incidental finding because we are looking for some other problem and we image the brain.  Presumably these have been present for the life of the patient and most of the time the archnoid cysts have just be a finding and not part of their problem.  Also, we presume that since these cysts are much bigger than what you describe, they must occur in various sizes.  Most all of these patients are "normal" with normal intellect.  The individual outcome for your daughter really can't be predicted accurately.  Hopefully, the cyst will not grow much, the brain will grow and produce enough space to fully develop (which based on history will be the case).  

As far as pain, I can't tell you.  Some patients are brought to our attention due to headache, but most are not and their complaints are not one of pain.  Based on this, one can't tell for sure concerning your daughter.  

I know that I have not truely answered your questions.  I wish that I could look into a crystal ball and tell you not to worry and your daughter will be whatever she wishes.  I gut feeling is that this will likely be the case, but each case can be different.  Let us know what happens.

Sincerely,

CCF Neuro MD

[bz]

Terry L:
Can't help much with your situation but would suggest if you would like speak to other parents who may have been in your situation go to www.braintalk.org.  Click on neuro conditions
A-L, then on Child Neurology.  I am sure there are parents there who have had kids with arachnoid cyst.

Good Luck