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Neurology (Expert Forum)
Atypical Arachnoid cyst
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Atypical Arachnoid cyst
by rew1648, Nov 08, 2004 12:00AM
Last March of this year my headaches suddenly went to 10+, 24/7, and 200mg of the ultram didn't touch it. An mri showed an arachnoid cyst, 2.6cm xx 2.0cm in the left cranial middle lobe with minimal mass effect.
An mri with contrast showed the followong:"Brain appears of normal signal intensity without focal abnormalities. There is no evidence of peripheral infarcts or space occupying lesions. There is a septated fluid collection noted in the anterior left middle cranial fossa, 2.6cm x 2.0cm with mild mass effect on the anterior tip. This appears to represent an arachnoid cyst however there is septation present and some of this collection may be in the subdural space rather than the subarachnoid space making this slightly atypical for an arachnoid cyst. There also appears to be some mild fluid enhancement of the septation. This does however appear to have fluid consistant with CSF density and has not changed in size when compared to the outside examination. No additional abnormalities are appreciated.
Impression: Septated fluid collection in the left middle cranial fossa with mild mass effect in the left temporal lobe unchanged from the previous examination of 3-30-04. There is some mild enhancement of the septation after the administration of Gadolinium and also septations are fairly unusual for a simple arachnoid cyst, therefore some of this may be adhesions within an arachnoid cyst versus some elevation of the dural with separate epidural collection as well. Followup is recommended."
What kind of specialist should I follow up with? I still have neuro symptoms.
An mri with contrast showed the followong:"Brain appears of normal signal intensity without focal abnormalities. There is no evidence of peripheral infarcts or space occupying lesions. There is a septated fluid collection noted in the anterior left middle cranial fossa, 2.6cm x 2.0cm with mild mass effect on the anterior tip. This appears to represent an arachnoid cyst however there is septation present and some of this collection may be in the subdural space rather than the subarachnoid space making this slightly atypical for an arachnoid cyst. There also appears to be some mild fluid enhancement of the septation. This does however appear to have fluid consistant with CSF density and has not changed in size when compared to the outside examination. No additional abnormalities are appreciated.
Impression: Septated fluid collection in the left middle cranial fossa with mild mass effect in the left temporal lobe unchanged from the previous examination of 3-30-04. There is some mild enhancement of the septation after the administration of Gadolinium and also septations are fairly unusual for a simple arachnoid cyst, therefore some of this may be adhesions within an arachnoid cyst versus some elevation of the dural with separate epidural collection as well. Followup is recommended."
What kind of specialist should I follow up with? I still have neuro symptoms.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Nov 15, 2004 12:00AM
You could either see a neurologist (perhaps one specializing in headaches), or a neurosurgeon. On the next MRI a special scan called a CINE flow study may be of benefit. This will try and ddetermine if the fluid collection is trapped or communicating with the other fluid around the brain. A ruptured arachnoid cyst could cause a sudden change in symptoms, but should resolve over time. Good luck, and sorry for the delay in answering.
Member Comments (2)
by rew1648, Nov 15, 2004 12:00AM
ok, truth be said, my neurologist says that mine is a normal brain. He can't explain my symptoms though; 10+headache, lurching gait to the right, weakness in my right hand (suddenly unable to hold a cup of coffee), loss of balance, tipping over, days of nausea, scattered negative scotoma in both eyes, sudden double vision, short term nenory failure, unable to retrieve words of objects that I can visualize. Shoot, I don't even recognize him when I see him every 3 months. He doesn't seem to notice that. I really need your help. This headache is getting worse with winter comming on. Please.
