Arachnoid cyst and athletics

[Luna0821]

My 16-year-old daughter was recently diagnosed with an arachnoid cyst of about 2 cm.  The neurosurgeon has already said it is not causing the symptoms that prompted the MRI (occasional dizziness and headaches).  She is an obsessed athlete: a goalie on the soccer team, swims competitively, and plays volleyball.  We have another appointment with the doctor next week and I feel he will prohibit these activities (with the possible exception of swim).   I'd like to be ready with some support for her if this comes to pass, as it would be a devastating turn of events.  My questions are:  What's the professional consensus on sports and arachnoid cysts?  Are there some adaptations that could make it possible for her to continue to play soccer?  What online resources for peer support are there?  Thanks.

[CCFNeuroMD JT, MD]

Dear Luna0821-

I must preface my answer by stating that it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist or neurosuregeon.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

Please allow me to give you a little bit of information about arachnoid cysts.  Most arachnoid cysts are fairly benign- the vast majority occur adjacent to part of the brain known as the temporal lobe within the Sylvian fissure (a space which separates the temporal lobe from the rest of the brain), although they may occur in other areas of the brain and spinal cord.  In essence, these cysts are cerebrospinal fluid-filled sacs which form between the brain (or spinal cord) and a layer that surrounds the brain known as the arachnoid membrane.  Primary arachnoid cysts are the most common, arising en utero during development.  On occasion, these cysts can also form later in life as a result of  meningitis, tumor, trauma, or following brain surgery.  Many people are asymptomatic, although those who develop symptoms usually do so prior to age 20.  Symptoms generally reflect cyst location and may include headache, seizure, nausea, vomiting, problems with balance, vertigo,  hearing and visual disturbances,.  If the cyst is located in the spinal cord, limb pain, paresthesias, and weakness may occur.  They are more common in males than females.

Although I am not a surgeon and therefore cannot give you a surgical perspective, I can tell you that the vast majority of patients with arachnoid cysts never require surgical intervention.  An indication for drainage/fenestration of the cysts would be manifestation of symptoms attributable to the cyst. I cannot imagine that your physician will restrict your daughter's involvement in sports.  Obviously, I have not seen her MRI and cannot make you this promise for sure, although I can assure you that most patients with these cysts need not restrict their daily acitivities.

Best of luck to you and your daughter, and thank you for your question.

Best,
JBT

[TLKD]

Hello, I too have been diagnosed with an arachnoid cyst measuring 2cm x 3cm which was revealed in an MRi and CT scan for an onset of migraines I had experienced. Since the findings I have went to three seperate doctors plus a neurologist who claims arachnoid cysts are nothing serious to worry about unless they are large enought that they press on an artery or intervein with blood flow. Most arachnoid cysts are benigh growths which stem from birth. They form as the skull grows and shapes during pregancy into infancy. As far as your daughter I have been told i could resume all activities just monitor any headaches in a log book. Should the cyst get bigger depending on the location they can fensterate the area and drain the cystic area, however there is a chance that it will come back. My doctor suggested leaving it alone and conitnue following up with MRI every two years unless symptoms get worse.
Best of luck to your daughter.

[Luna0821]

Thanks so much for your response.  I'll ask careful questions about his rationale for restrictions if this arises during the appointment.