Re: arachnoid cyst

Posted By CCF Neurosurgery MD/gm on May 04, 1998 at 23:23:22:

In Reply to: arachnoid cyst posted by Jane   on May 02, 1998 at 21:32:42:






I was found to have an arachnoid cyst last year on my left frontal lobe. It's smallish, about 2/3 the size of my eyeball on the MRI. It is new, because three years ago I had an MRI that was normal. I am 22, with a history of thyroid cancer. The MRI was done because I've had bad headaches and vertigo. Now I've developed severe trouble sleeping, and am on ambien and doxepin, plus fasciculations, myoclonic twitching in my hands and ankles, pulsatile tinnitus (whooshing, esp. when I lay down), aching pain in my eyes, and a tremor. I have had many neurological tests, including a SPECT scan, which showed the cyst was inactive. There were other abnormalities on it, a +4 in my cingulate gyrus, and some diminshed function in my left temporal lobe, and two holes, prefrontal orbital. What I'm really wondering is can a cyst in this placement cause increased intracranial pressure? Could increased pressure be seen on a SPECT scan? Does anyone have any idea why the cingulate would be so overactive, ie. does that indicate any physical problems? The neurologist mainly interpreted the increase in psychological terms, but since I still have bad headaches, dizziness, and insomnia, I wondered if it could somehow be related to pressure. I have a very bad feeling of pressure in my head, like I want to "uncork" it! It gets worse on laying down. Thanks. Anyone can e-mail me with any info: ***@****

Dear Jane :
The problem you describe is a rather unusual combination. Based on your
description of the MR findings I do not think that the problem is related
to the arachnoid cyst. However please remember that I do not have the
luxury of having see the actual images. I recommend that you seek the
opinion of a neurologist that specializes in epilepsy and sleep disorders
as he/she may be best suited to determine the source of your problem as
well as the needed treatment. Pulsatile tinnitus is typically associated with
vascular anomalies in the brain vessels (especially dural areterio-venous
fistulae). This may necessitate an angiogram to further delineate the cause
of this problem but I think seeking the opinion of an epileptologist may be a good
first step.
If you have any further questions please write back. Good Luck!