Retrocerebellar arachnoid cyst of the brain

Cystic formations in the cranial cavity always cause well-founded concern among both specialists and their owners. One of the variants of such cavities is a retrocerebellar cyst, which is detected in approximately 4% of healthy people and gives symptoms in only a fifth of its carriers.

Having set out to learn more about this cyst, the reader will find a large amount of information on the Internet, but not all of the information corresponds to reality. Most dubious sources present a retrocerebellar cyst as a kind of intracerebral accumulation of fluid in the place of dead neurons, but in reality it is a cerebrospinal fluid cyst lying outside the brain rather than inside it.

Intracerebral cysts, in other words, cerebral cysts, actually form in the brain itself after necrosis due to a stroke, tumor or injury. The cerebrospinal fluid cyst owes its appearance to the pathology of the arachnoid membrane, therefore it is also called arachnoid, and identifying it with a cerebral cyst is fundamentally incorrect.

The term “retrocerebellar” is not a characteristic of the cyst itself, but an indication of its location behind the cerebellum (cerebellum), in the region of the posterior cranial fossa, as shown by MRI data, through which these same cysts are detected.

Thus, a retrocerebellar cyst is a cavity formation in the back of the skull, formed by the arachnoid mater, collagen fibers, containing cerebrospinal fluid and lying between the surface of the brain and its arachnoid membrane.

example of cystic expansion of the retrocerebellar arachnoid space

In most cases, a retrocerebellar cyst is discovered accidentally, in young adults who, for one reason or another, have had an MRI. As a rule, the reason for examination is neurological symptoms, which are not always associated with a cyst. A small-sized retrocerebellar cerebrospinal fluid cyst can be asymptomatic and is extremely rarely accompanied by any negative effects on the brain itself.

Definition, classification

Such a cyst is a small benign tumor that develops at the site where brain tissue has begun to die. At the very beginning, the affected area begins to expand, and then the resulting cavity is filled with cerebrospinal fluid. In some cases, it can resolve on its own, but sometimes the cyst begins to enlarge, which increases the risk of health problems.

Retrocerebellar cyst includes two types: retrocerebellar and arachnoid. The first involves the formation of a tumor affecting the gray matter. The peculiarity of the manifestation of the second is its direct effect on the arachnoid membrane of the brain. Their combination causes increased symptoms and increased complexity of treatment.

According to the ICD classification, such a cyst has code G93.0. It is local in nature and cannot spread to healthy areas. In this case, the localization site can be any part of the brain tissue. Most often, the cyst appears in the frontal and occipital lobe. Based on the location of its formation, doctors divide the disease into two types: lower and upper cyst.

The main division into types implies two options for the development of pathology:

Primary. It is congenital and is detected in the maternity hospital.
Secondary. Appears at any moment in life.

Adults are less susceptible to the disease because... most often it belongs to the first type.

If the cyst affects part of the brain, then it is called cerebral (intracerebral) and is more dangerous.

How is an MRI performed?

To ensure that the procedure is as informative as possible and that the images are clear, experts recommend performing magnetic resonance imaging in closed-type tomographs. Before starting the study, the patient must change into clothes without metal structures, take off his shoes and lie down on a retractable table. If the doctor has prescribed additional contrast enhancement, a special drug is injected into a vein, which is distributed throughout the circulatory system in just a few minutes. Then the table moves inside the tomograph, where the research process takes place.

Maintaining immobility is the main requirement for the patient! Remember that even minimal movements can lead to a decrease in the information content of the procedure.

It is also worth noting that when performing magnetic resonance imaging, a specific loud noise is observed. If this scares you, you can use earplugs.

Patients generally tolerate MRI well. Inside the tomograph there is good lighting and ventilation, there is a loudspeaker, as well as a panic button for emergency stop of the study.

Dimensions

A small cyst can be present in a person for many years without showing any signs. If it is detected, treatment is usually not required. A person will only have to visit the doctor more often and check with the help of an image whether it has begun to grow. If the cyst remains small in size, it is considered normal, and the person can live as usual. However, if it increases or there are serious reasons for its formation, treatment will still be required.

Cyst sizes:

Up to 2 mm – compactions of small size that do not require treatment.
Up to 10 mm – moderate size, refers to the average degree of danger.
Up to 10 mm, stretched to 120 mm in length - a dangerous cyst that causes severe symptoms.

What size of a retrocerebellar cyst of the brain is dangerous is the first thing that interests people who learn about the neoplasm. A cyst up to 10 mm requires special attention only if it enlarges. Only a cyst that is 10 mm thick and manages to stretch tens of millimeters in length can be classified as dangerous. With rapid growth, the tumor can increase several times in a couple of months. This phenomenon is typical for infectious diseases that provoke the appearance of a cyst.

Is there effective prevention?

As such, there are no preventive measures against retrocerebellar cysts; everything depends on determining whether the formation is congenital or acquired. If it is congenital and the size does not change over time, then no special procedures are used.

A preventative neck massage may be prescribed.

or certain types of drugs that keep blood vessels in good shape.

If the cyst was formed under the influence of external causes, then prevention is carried out depending on the factors that influenced its formation.

Causes

This type of cyst can appear without any obvious reason. This makes it much more difficult to identify. There are quite a few factors that can trigger its development. These include:

Circulatory disorders;
Head injuries, concussions;
Inflammatory diseases caused by infectious exposure;
Serious negative brain changes;
Performed brain surgeries;
Previous stroke;
Heredity;
Birth injuries, negative effects on the fetus of medications taken by the mother during pregnancy.

All people affected by the problems listed above are at risk. The increased likelihood of cyst formation requires observation by a doctor. You need to visit him at least once a year to exclude unexpected development of the disease.

Symptoms

A small cyst does not cause any symptoms, but with its dynamic growth, a person gradually begins to feel more and more unpleasant feelings. When it increases to a critical size, the patient’s condition can become extremely serious. The following symptoms are characteristic of a cyst:

Deterioration of psycho-emotional state. Depressive thoughts, sleep disturbances, apathy, fatigue.
Headache. In addition to pain, there is severe dizziness and a feeling of strong pressure on the skull. In the later stages, pain can manifest itself in the form of severe migraines.
Problems with the senses. Poor hearing, tinnitus, double vision.
Decreased brain activity. Deterioration of concentration and thought processes.
Paralysis. It can be local in nature, affecting only one part of the body, but sometimes it affects all limbs. In some cases, it is combined with epilepsy and seizures.
Development of hydrocephalus. In parallel with this, feelings of nausea, drowsiness, nervousness, and fainting appear.

If the cyst affects the back of the skull and puts pressure on the cerebellum, then the person may have problems with the vestibular system.

A person with a cyst of this type will be refused entry into the army if it is manifested by neurological abnormalities (paralysis, epilepsy) or problems with the sensory organs.

How does the disease manifest itself?

The symptoms of the anomaly have a direct relationship with the size of the tumor. Localization and educational factors are important. If the cyst continues to increase in volume or the pressure of the substance in it increases, the patient may experience pronounced manifestations. At the same time, the formation of small cysts that stop their growth does not provoke symptoms. The main reasons for the progression of the disease are:

neuroinfectious microorganisms;
long infectious process;
malfunctions in the functioning of the circulatory system of a chronic nature;
autoimmune disorders.

The patient exhibits the following signs of an unstable condition:

pain in the head area;
discomfort from a feeling of pulsation inside the skull;
temporary hearing problems;
presence of noise in the ear canals;
a feeling of fullness in the head and a surge in pressure;
disturbances in visual abilities (formation of spots, blurriness, bifurcation);
paralysis of the arms or legs, complete or partial;
seizures;
sudden loss of consciousness;
numbness of body parts of a temporary or permanent nature.

Diagnostic measures

To prevent the development of an anomaly and establish a timely correct diagnosis, it will be necessary to rely on all the patient’s existing complaints along with the clinical picture. Medical staff use clinical tests such as magnetic resonance imaging.

Features of cysts in children

A child whose cyst begins to grow will experience the same symptoms as any adult. However, they can be very pronounced, which will cause more discomfort. The most common cause of this problem in children is meningitis. Therefore, after recovery, you should regularly check with a doctor to eliminate risks.

The cyst is often found in infants. If it is not noticed in a timely manner, then there is a risk of divergence of the bone sutures in the baby. In this case, hydrocephalus will most likely begin to develop, and in the future the child will have problems with mental and physical development.

When a cyst is detected in a baby, it is important to confirm the diagnosis as quickly as possible using ultrasound and carry out intensive therapy, including surgery.

Diagnostics

Making a correct diagnosis is one of the most important components of treatment. If done incorrectly, there is a risk of death. So, in the case when a malignant tumor is confused with such a cyst, a surgical operation may be prescribed, which in no case should be done for dangerous tumors.

First, the doctor conducts a survey, drawing up a complete picture of the patient’s symptoms. After this, CT, MRI and ultrasound are necessarily prescribed, and the latter procedure must be carried out with intravenous administration of a contrast agent, which will help determine whether the patient has a malignant or benign tumor. The doctor also prescribes other examinations to accurately determine the cause of the cyst formation. It is important to do this right away in order to quickly begin treatment and eliminate the repeated negative impact of the root cause.

The patient is additionally prescribed the following procedures:

Blood analysis. Cholesterol and coagulability indicators can clarify the condition of the blood vessels and the presence of blockage, due to which a cyst often begins to grow. The presence of infectious and autoimmune diseases is also checked.
Heart check. The procedure is required to identify problems related to heartbeat and heart health.
Doppler ultrasound. Detection of vasoconstriction in the head and neck will mean that an insufficient amount of blood is supplied to the brain, a deficiency of which leads to the death of particles of brain tissue and the appearance of tumors.
Pressure monitoring. Pressure changes can cause micro-strokes, due to which a cyst begins to develop.

Immediately after identifying the expansion of the retrocerebellar space and making a diagnosis, the patient is prescribed treatment. It is necessary to start it as quickly as possible in order to exclude further deterioration of the condition and all kinds of risks.

Retrocerebellar type formation

This is a fairly rare pathology, which is diagnosed in 5% of the population.

This neoplasm combines several types of neoplasms that differ in location:

arachnoid,
intracerebral - can form in any part,
inferior retrocerebellar.

This cyst is spoken of when the tumor is localized only in the cerebellum. In this case we observe:

migraine;
vomit;
paralysis and paresis;
problems with balance;
the image before your eyes becomes unclear;
decreased concentration;
deterioration of character;
loss of consciousness;
twitching of the eyeballs;
deterioration of thinking;
violation of orientation in space and time;
decreased muscle tone.

Treatment

The approach to treatment should be as serious as possible. This is the only way to achieve a positive result. But equally important is how experienced the doctor treating the patient is. Therapy involves two approaches: medication and surgery.

Drug treatment

The effectiveness of drug therapy is observed only in the initial stages of the disease. In most cases, after a course of taking all the necessary medications, the tumor begins to shrink on its own. When prescribing medications, the main goals are to improve blood supply and ensure the resorption of folds and scars.

The following groups of medications are prescribed:

Antiplatelet agents (Aspirin, Pentoxifylline). They normalize cholesterol levels, normalize blood clotting, and also help dilate blood vessels when they narrow.
Antioxidants (Sinergin). Strengthen brain tissue, increase resistance to hypertension.
Nootropics (Nootropil, Cerebramin). Promotes increased supply of oxygen to brain tissues.
Anticoagulants (Longidaza). Help eliminate adhesions in brain tissue.
Antihypertensive drugs (Capoten, Enalapril). Normalizes blood pressure when it increases.

All medications are prescribed individually. In some cases, taking certain groups of drugs is not required.

If an infection is detected, immunomodulators and antibacterial substances may be prescribed.

Surgical intervention

If there are no positive changes after drug therapy, the patient is prescribed surgery. It is also used immediately for certain infectious diseases, because In this case, it will not be possible to get rid of the tumor with medications. The operation can also be performed at the request of the patient if he experiences severe pain, paralysis or other pronounced symptoms.

Several types of operations are used:

Endoscopic surgery. A small hole is made in the patient’s skull, an endoscope is inserted, the walls of the cyst are cut through and the fluid is removed.
Shunting. A special device is installed that drains fluid into other cavities inside the body.
Removal of the tumor. The skull is opened and the cyst is completely removed.

Recovery after surgery is under the supervision of doctors. In all cases, there is virtually no risk of relapse, but complications may occur.

Prognosis, complications

If left untreated, the patient's condition will worsen if the cyst continues to grow. As a rule, this leads to unbearable pain, which ends in rupture of brain tissue. The patient will experience severe bleeding, accompanied by inflammation, which ultimately becomes the cause of death. This is the main reason why the development of a retrocerebellar arachnoid cyst of the brain is dangerous.

But even with proper treatment and surgery, a person may experience complications. The prognosis is usually positive if the patient fulfills all the doctors’ requirements. However, sometimes problems arise:

High blood pressure;
Intense headaches;
Decreased immunity, accompanied by malaise;
Disorders of the sensory organs, speech apparatus, and motor function;
Convulsive seizures;
Hypermobility or developmental delay in children;
Psychological disorders expressed in behavior and communication with people.

Such consequences in the postoperative period do not occur so often, and with drug treatment they are very rare. However, it is extremely important to maintain a healthy lifestyle and adhere to medical recommendations throughout the recovery period.

Development options

Most often, the cyst does not interfere with brain activity. In case of an increase in the volume of the tumor and the appearance of neurological abnormalities, the options for the development of the cyst will depend on the timeliness of diagnosis and correct treatment.

When pressure increases in the head, serious problems with speech, hearing, vision and memory can occur. Persistent neurological disorders may occur. A sharp increase in the size of the tumor can provoke its rupture and death of the patient. If diagnosis and therapy are carried out on time, the prognosis is quite optimistic and after treatment the patient recovers 100%.

Traditional methods against cysts

Some people tend to prefer traditional methods. For small tumors, they can have a positive effect, but their effect has not been proven in any way, which calls into question the meaning of their use. A cyst can be dangerous, so you should not try to treat it yourself. It is better to resort to medically proven methods that will lead to the desired result.

However, if you really want to, you should take into account two recipes:

Hemlock. Pour 50 g of seeds or flowers into a liter of vegetable oil, let it brew for 3 weeks, shaking the jar from time to time. After this, you will need to strain the oil through cheesecloth. Use as nasal drops daily.
Burdock. Fresh leaves of the plant need to be washed, crushed, and then squeezed out the juice. It should be put in the refrigerator for 5 days, before adding alcohol to it (5 units of alcohol per 1 unit of juice). Take 2 tbsp. l. in the morning for 3 weeks.

The use of such remedies for large cysts will not give results and is highly not recommended.

Some people prefer to turn to people with psychic abilities to be healed of their cyst. It is better to abandon such ideas and begin treatment with the help of doctors.