Arachnoid & thornwaldt cysts

[bulls]

I have a history of neurological damage of both medial and temporal lobes, hippocampus, hypothalamus, thalamus and pituitary (microadenoma) (I think the damage to the cortex & brain stem went down)

It was all diagnosed 15 years ago as encephalitis and I have quite a few problems from it all - problems that all seem to be getting slowly worse with time.

Anyway, the last MRI was in 2006 until I went for one last week.

The result is that the pituitary and hypothalamus remain unchanged. However there are 2 changes

"the prominent CSF space anterior to the left temporal pole has a rounded well-circumscribed appearance, likely representing an arachnoid cyst." It's 2cm

plus

"an incidental Tornwaldt cyst is identified in the nasopharynx measuring 10 x 8mm"


I have so many medical issues from the previous damage that has been getting worse with time so I don't know if they're naturally getting worse from the previous encephalitis or if it's from the new cysts recently found.

Are they (the cysts) big enough to be causing me any problems?

Are they located anywhere that they could be pressing on anything and causing me problems from the pressure on the other neurological part?

Any advice would be very welcome

Thanks

[msjcobbs]

A related discussion, what should i do was started.

[bulls]

Thanks Doctor - thanks a lot.

What about the Tornwaldt cyst?  Is this of a size that could cause any problems?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Arachnoid cysts are sacs filled with cerebropsinal fluid (CSF) which is the fluid that normally bathes the brain and spine. This fluid is normally located in the part of the brain called the subarachnoid space.

Most commonly, these are primary arachnoid cysts, cysts that are present from birth and result from a minor developmental problem that occurred while the brain was developing. Secondary arachnoid cysts are those that develop secondary to trauma, infection, or after brain surgery. It is not always possible to tell if the cyst you have is primary or secondary. Was there on the previous MRI(s)?

Some cysts resolve spontaneously, but most arachnoid cysts remain the same size or increase in size only slightly in adulthood, and others fluctuate over time.

If an arachnoid cyst is deemed to be causing symptoms or is pressing on surrounding structures (which would most often be evident on your MRI), surgical opening (fenestration) of the cyst and other surgical interventions could be done to correct it, but this is rarely necessary because the vast majority of arachnoid cysts are benign, do not grow, and do not cause symptoms. Sometimes, re-imaging to take another look at it after a few months or years may be indicated. It is a good idea for you to ask your physicians about more information about the cyst, what the implications of having it is, so you can have a good understanding of it; continued followup with your neurologist is recommended to determine if you are having symptoms from the arachnoid cyst. You may also need a referral to a neurosurgeon if you are having symptoms from the arachnoid cyst.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.