return of arachnoid cyst on brain stem

On November 3rd of 2007 I Had surgery to remove an arachnoid cyst on the left of brain stem measuring 14 x 17 cm.  Had been having pain in both arms, but considerably worse in right arm, numbness and weakness in arms , bad headaches, trouble sleeping, fatigue.  My problems started almost 3 years ago, and wasn't diagnosed with cyst until September 2007, after neurolgist decided, after lots of tests and specialists, to do MRI of brain to rule out MS.  When I had the surgery,  the surgeon, drained and removed as much of the cyst as he could, saying there was a very slim chance of it returning.  The surgery was pretty intense, as you would imagine.  About 6 weeks after surgery, my symptoms started to return.  In February I had another MRI, which shows the cyst is back, and now is 17 x 21 cm.  My doctor says to leave well enough alone, and wait until my symptoms get worse or see if cyst grows.  My question is how often should I have an MRI to check to see if it is growing, and if I do end up having to have surgery again, how do I know it won't come back again.  What problems can a cyst cause if left alone?  What about a shunt?

[dr_simran]

Hello Dear,


Sometimes after surgery, a portion of cyst may remain due to remodeling of the bone and chronic shoft of brain contents. Untreated, arachnoid cysts may cause permanent severe neurological damage due to the progressive expansion of the cysts or hemorrhage .With treatment most individuals with arachnoid cysts do well.
Drainage by needle aspiration or burr hole can be done. While these procedures are relatively simple, there is a high incidence of recurrence. In the past, doctors placed shunts in the cyst to drain its fluid.  Now with microneurosurgical techniques and endoscopic tools that allow for minimally invasive surgery, more doctors are opting to surgically remove the membranes of the cyst or open the cyst so its fluid can drain into the cerebrospinal fluid and be absorbed.You should disuss the pros and cons of revision surgery with the neurosurgeon as the recurrence may still be there after the removal.

Refer Hello Dear,


Sometimes after surgery, a portion of cyst may remain due to remodeling of the bone and chronic shoft of brain contents. Untreated, arachnoid cysts may cause permanent severe neurological damage due to the progressive expansion of the cysts or hemorrhage .With treatment most individuals with arachnoid cysts do well.
Drainage by needle aspiration or burr hole can be done. While these procedures are relatively simple, there is a high incidence of recurrence. In the past, doctors placed shunts in the cyst to drain its fluid.  Now with microneurosurgical techniques and endoscopic tools that allow for minimally invasive surgery, more doctors are opting to surgically remove the membranes of the cyst or open the cyst so its fluid can drain into the cerebrospinal fluid and be absorbed.
Refer http://www.skullbaseinstitute.com/arachnoid_cyst.htm
Best

Best

[tazmanforever]

Although a fenestration of the cyst is helpful, cysts can be congenital.  My father had cysts on his arms and legs, brothers on chest and arms and oldest brother had one on his head.  My sub-arachnoid cyst is in the posterior fossa of the brain.

Although we have all had cysts removed, (mine was fenestrated), they all grew back and has been a lifetime process for us, so in answer, that may be your case.

I get an MRI done once a year and several CT Scans throughout the year to monitor my cyst.

Hope this helps.

[shan95]

Thanks so much for the info.

[shan95]

Thanks for the response.  I don't know anybody who has had a cyst on the brain, and I got most of my info from the internet.  Wish I would have found this forum before my surgery.  Getting info from doctors is like pulling teeth.  Now I guess I just wait and watch.  Thanks

[aaaa12]

HI , I am 36 and I had a fenestration surgery last year in March ( 2009 ) for a cyst of 12 cm right side.( Canada-Montreal)
  MRI done after surgery , after 5 months showed that the cyst was back, same size , now my symptoms are more accentuated as before, numbness on my lefts side , fatigue and sometimes feel like vomiting.
I am trying to have a normal life , I do not want to go trough any other surgeries. I have seen 10 doctors and no clear answer was received from any of them. I believe it all depende son our life style, nutrition and level of stress.