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Neurology (Expert Forum)
cyst?
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cyst?
by bklk, Nov 12, 2004 12:00AM
Hi
I am a Previously healthy 39yr male.
I have been suffering severe headaches since Sept 1. Following a sore throat,
Ultimately determined to be viral meningitis 23WBS 89%Lymphocytes protein 60 normal glucose.
2 mri and 2 ct read normal.
MRA bormal
2nd LP showed 1 WBC normal after 5 weeks
Still can’t do anything due toheadaches. Mostly rear of head and top and neck pain.
Recently developed face paresthesia that starts below eye and travels down to forearm.
Opthalmology exam fine, new MRI showed:
The radiologist noted a small (the doctor described it as “millimeters”) possible arachnoid cyst or congenital finding of slight prominence of the CSF in the region of the quadrigeminal plate cistern.
I looked this up and see a high incidence of coincidental findings, and asymptomatic cysts that are larger than anything I have but on the other hand I see an association with hydrocephalus? I wonder if it could be related or might merit comparison to earlier MR studies
I was told it was still viral meningitis and give medrol does pack which reduced pain 20% for a week.
Is 2 ˝ months headache following viral meningitis far fetched?
Between the all the CT and mri I have on and off notation of sinusitis or mucosal dilation that I don’t seem to have symptoms of? Possible?? But the tingling?
Given a blood patch for possible CSF leak, no help came from that.
What is the treatment for these cysts, how much risk and what success?
Any opinion as to the likelihood of this causing symptoms of my type?
What else could it be if anything?
Regards,
I am a Previously healthy 39yr male.
I have been suffering severe headaches since Sept 1. Following a sore throat,
Ultimately determined to be viral meningitis 23WBS 89%Lymphocytes protein 60 normal glucose.
2 mri and 2 ct read normal.
MRA bormal
2nd LP showed 1 WBC normal after 5 weeks
Still can’t do anything due toheadaches. Mostly rear of head and top and neck pain.
Recently developed face paresthesia that starts below eye and travels down to forearm.
Opthalmology exam fine, new MRI showed:
The radiologist noted a small (the doctor described it as “millimeters”) possible arachnoid cyst or congenital finding of slight prominence of the CSF in the region of the quadrigeminal plate cistern.
I looked this up and see a high incidence of coincidental findings, and asymptomatic cysts that are larger than anything I have but on the other hand I see an association with hydrocephalus? I wonder if it could be related or might merit comparison to earlier MR studies
I was told it was still viral meningitis and give medrol does pack which reduced pain 20% for a week.
Is 2 ˝ months headache following viral meningitis far fetched?
Between the all the CT and mri I have on and off notation of sinusitis or mucosal dilation that I don’t seem to have symptoms of? Possible?? But the tingling?
Given a blood patch for possible CSF leak, no help came from that.
What is the treatment for these cysts, how much risk and what success?
Any opinion as to the likelihood of this causing symptoms of my type?
What else could it be if anything?
Regards,
Doctor's Answer
by CCF-Neuro-M.D.-CS, Nov 16, 2004 12:00AM
Without looking at the scan I cannot fully comment on your situation. If it is a tiny cyst and there is no evidence of compression on the brain, it is most likely an incidental finding. I would encourage you to seek the opinion of another doctor if you are unsure. Persistent headaches after viral meningitis can be seen. Also, this could have triggered a migraine like headache, which is now causing the additional symptoms. A consultation with a neurologist who specializes in headaches would be reasonable. Good luck.
I did have ANA, SED, lyme, West Nile, and most tests run from blood but no CSF PCR for the HSR or enterovirus.
My first CBC showed absolute lymphocytes of .43 reference 1.2-4.0! I can only guess this was due to 5 epidural steroid injections post surgical back pain, the last 3 days prior to onset. I also had 3 rounds of antibiotics prior to the fist CSF culture. 1 for dental work, 2 for sinusitus.
How long could these supress a bacterial cause (perhaps from sinus?) and keep it atypical? Mycrobacterial?
How bout candidas fungal introduced on a epidural needle, given my reduced immune state? I read a Mayo study showing it on 35% of needles even after skin prep?
I'm grateful! Thanks.