Is surgery required

[Lozzycooper]

Hi there, I wonder if you assist.  Approx 4 years ago, I started to have pins and needles in my fingers and then my feet, which to be honest I ignored.Soon after, had my first 'attack' of syptoms, wherby I was admitted into hospital fpr  tests for MS, as the Neurologist was sure this was what it was. Memory, co-ordination, power in limbs on left hand side and ability to sleep all greatly affected.  Secere pins and needles on face, hands, feet and numbness down left hand side of body, with lack of power and easily tired have remained in the last 4 years.  the initial MRI scan showed a small cyst, but no evidence of MS,  LP also carried out, during this time, which was negative. I have taken Amitriptyline to help me sleep, which results in my day time pins, needles etc to be managable.  Recently my doc sent me for another MRI as symptoms steasdily getting worse and increase of dosage no longer working.
The result of my recent MRI scan is:-
There is an enlargement of the supra-verm,ian and probably also quadrigeminal ciste4ns, possible due to a large arachnoid cyst, with flattening of the inferior lying cerebellar vermis and some effacement of its sulci. This sulcal effacement would suggest that the cyst is causing mass effect rather than just a secondary expansion of the CSF space.  The intracranial grey and white matter return normal signal intensity.  The ventricular system, basal cistrns and sulci are otherwise normal in size and configuration. The craniocervical junction and midline structures appear satisfactory. Normal signal flow void was returned from the major intracranial vessels.opinio:- Enlargement of the supra-vermian and quadrigeminal cisterns, possibly due to a large arachnoid cyst resulting in flattening of the cerebellar vermis and some sulcal effacement.  No other abnormality, in particular no evidence of demyelination.

This incidental finding has resulted in my neurologist requesting me to see a neurological surgeon to see if surgery is required. Do you think these findings relate to my symtoms, and if so, what do you think the chances are of surgery happening.  This cyst, I am told is lthe same original one, but has grown in size.  Thank you for taking the time to read my question.LA.  

[Tuckamore]

Hello Lozzy,

Welcome to the Pain Management Forum of MedHelp. I am glad that you found us. Your condition is very interesting. I am sorry for all the symptoms it has caused you.


I am far from an expert or an neurosurgeon. My opinion is only that, a personal opinion. I have a small arachnoid cysts on one of my spinal nerves roots. With my approval the neurosurgeon has decided to observe the cyst as it does not cause me any major problems. I know a bit about these cysts.

They normally treat these cysts based on their location, size and the symptoms it presents for the patient. 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. Symptoms usually resolve or improve with treatment if treated in a timely manner. Remember this is only my personal opinions and should never be considered a medical opinion.

Your neurosurgeon will be best able to provide you with solutions and answers. I am guessing that they will at least drain and shunt the cyst. The thought with my cyst is that in order to remedy the situation it would have to be removed as draining it would only allow it to fill back up.  

I am glad that they repeated the MRI. I hope it is at least a relief to you that they have found the reasons why you are experiencing these symptoms. Please let us know how you are doing. I will look forward with interest to your updates. Good luck to you and take care.

[nurseaudrea]

I think the answer to your question is better suited for the Neurosurgeon. It sounds like the cyst is growing and could be causing your symptoms. I am sorry you are having so many symptoms and wish the best for you.

Audrea

[MontanaGurl]

I do not have to much experience with what is going on with you but, I feel your frustration.  When do you see the nerologist?  Has your doctor said anything that indicates to you that surgery might be an issue or alternative to taking meds?

montanagurl