Symptoms, diagnosis and treatment of arachnoid cyst of the brain

Classification

According to the International Classification of Diseases (ICD-10), pathology is assigned code Q04.6.

The classification of the disease is related to the location of the pathology, and the following types are distinguished:

1. Arachnoid - located between the three membranes of the brain; in children, this neoplasm can provoke hydrocephalus and an increase in the volume of the skull. When diagnosing a cyst in adults, treatment is most often not required, of course, if there is no growth of pathology.
2. Retrocerebellar - localized inside the organ, this neoplasm can lead to the death of brain cellular structures.
3. Subarachnoid is a congenital neoplasm that can cause unsteadiness in gait, convulsions and pulsating sensations inside the skull.
4. Arachnoid cerebrospinal fluid cyst - occurs in people of an older age group or those with atherosclerotic changes.

In accordance with the causes of the pathology, arachnoid cystic pathologies are divided into:

• congenital - their development occurs during the period of fetal growth in the mother’s womb, as well as during asphyxia of the child.
• acquired - develop after certain diseases, as well as under adverse environmental influences.

There is a classification of cysts according to symptoms: progressive - clinical signs increase, which is mainly due to an increase in the volume of the cystic cavity; frozen - are in a latent state and do not increase in size.

Important! To choose the correct and most effective therapy, it is very important to correctly classify the cyst.

Prevention

To prevent the development of cysts in the brain, you should adhere to the following rules of prevention:

• Treat all infectious diseases and brain diseases in a timely manner.
• Avoid exposure to provoking factors during pregnancy: give up bad habits, eat right, do not take medications without a doctor’s prescription.
• Ensure proper management of pregnancy and childbirth.
• Avoid overexertion and stress.
• Avoid head injury. When engaging in traumatic sports, wear a protective helmet.
• If your blood pressure is high, take measures to reduce it.
• Stop smoking and do not consume alcohol.

Dimensions and norm

Patients are often interested in the question of the normal size of the cyst and the volume at which surgical intervention is necessary.

It must be said that we can speak of normality only in the absence of a cystic neoplasm; if there is a cyst, then this is already an anomaly, and its size essentially does not matter much.

This type can have different sizes, but the cyst still cannot grow very much. Brain fluid resists its growth. If the size of the cyst is 1-2 mm, it is considered small; if the neoplasm grows to 1 cm, it is considered medium; cysts larger than 1 cm are considered large.

When diagnosing small cysts, doctors, as a rule, do not prescribe treatment, but choose a wait-and-see approach and simply monitor changes in the volume of the tumor. Large cysts are treated surgically; surgery is also indicated for medium-sized tumors when symptoms appear.

Treatment of arachnoid cyst.

As I said above, most congenital arachnoid liquor cysts are asymptomatic and do not require any treatment. Sometimes a neurosurgeon may recommend dynamic monitoring of the size of the cyst; for this, it will be necessary to periodically perform computed tomography or magnetic resonance imaging.

In rare cases, when an arachnoid cyst is accompanied by the symptoms described above and has a mass effect, surgical treatment is resorted to.

In some cases with a sharp deterioration, due to rupture of the arachnoid cyst or hemorrhage into it, urgent surgical treatment is resorted to.

There is no standard size for an arachnoid cyst. Indications for surgery are determined taking into account the location and symptoms of the arachnoid cyst, and not just its size. This can only be determined by a neurosurgeon during an in-person examination.

Absolute indications for surgery:

1. intracranial hypertension syndrome caused by an arachnoid cyst or concomitant hydrocephalus;
2. the appearance and increase of neurological deficit.

Relative indications for surgery:

1. large “asymptomatic arachnoid cysts” that cause deformation of neighboring lobes of the brain;
2. progressive increase in cyst size;
3. deformation of the cerebrospinal fluid tract caused by the cyst, leading to disruption of the cerebrospinal fluid circulation.

Contraindications for surgery:

1. decompensated state of vital functions (unstable hemodynamics, breathing), terminal coma (coma III);
2. the presence of an active inflammatory process.

There are three possible options for surgical treatment of arachnoid cysts. Your treating neurosurgeon chooses the tactics, taking into account the size of the cyst, its location and your wishes. Not all three methods are suitable for all arachnoid cysts.

Evacuation of an arachnoid cyst through a burr hole in the skull using a navigation station. The advantage is simplicity and speed of implementation with minimal trauma to the patient. But there is a drawback - the high rate of cyst recurrence.

Open surgery, that is, craniotomy (cutting out a bone flap on the skull, which is placed in place at the end of the operation) with excision of the walls of the cyst and fenestration (drainage) into the basal cisterns (cerebrospinal fluid spaces at the base of the skull). This method has the advantage of allowing direct examination of the cystic cavity, avoiding a permanent shunt, and is more effective for the treatment of arachnoid cysts consisting of multiple cavities.

Shunt surgery with installation of a shunt from the cyst cavity into the abdominal cavity or superior vena cava near the right atrium through the common facial vein or internal jugular vein. Many foreign and domestic neurosurgeons consider shunting of an arachnoid cerebrospinal fluid cyst to be the best treatment method, but it is not suitable in all cases. The advantage is low mortality and low rates of cyst recurrence. The disadvantage is that the patient becomes dependent on the shunt, which is installed for life. If the shunt becomes blocked, it will have to be replaced.

Complications of the operation.

Early postoperative complications - liquorrhea, marginal necrosis of the skin flap with dehiscence of the surgical wound, meningitis and other infectious complications, hemorrhage into the cyst cavity.

Causes

Primary (congenital) cysts are formed due to abnormalities in the developing fetus, most often this occurs under the influence of the following factors:

1. intoxication of the fetus with narcotic substances, alcohol, nicotine, medications that have a teratogenic effect;
2. intrauterine infection of the fetus with viruses;
3. irradiation;
4. severe overheating of the body during pregnancy.

In addition, the formation can occur with Marfan syndrome - this is an anomaly of connective tissue, as well as with pathologies of the corpus callosum.

Secondary pathologies can develop when:

1. brain injuries;
2. pathological processes in the brain, for example, degenerative;
3. in the presence of infections;
4. deterioration of cerebral circulation.

In addition, pathology can be observed after surgery.

The mechanism of development of this neoplasm is quite complex and is associated with impaired circulation of the cerebrospinal fluid. As a result, a cavity filled with cerebrospinal fluid is formed.

Pathogenesis

A cyst in the brain can develop under the influence of unfavorable factors observed during the period of intrauterine development of the fetus. In particular, this may be associated with hypoxia , intrauterine infections, the use of certain medications by a woman, etc. The cause of this formation may also be intrauterine intoxication as a result of smoking or alcohol addiction of the mother.

Acquired cysts develop as a result of injuries, inflammatory diseases, and circulatory disorders. In dystrophic and degenerative processes, the cyst can replace cerebral tissue. The growth of the cyst can be facilitated by strokes , difficulty in venous outflow and other vascular problems.

Cystic-gliotic changes also lead to the formation of cysts. Speaking about what cystic-gliotic changes in the brain are, it should be noted that with this pathology there is a proliferation of tissue responsible for the delivery of nutrients to neurons. This transformation leads to disruption of the normal functioning of the brain. As a result, the neurons die and scar tissue forms instead of healthy tissue. Against the background of pathological processes, a cerebrospinal fluid cyst and other types of cysts can form. A cerebrospinal fluid cyst is a formation with liquid contents, which in some cases can lead to the development of neurological symptoms.

Symptomatic manifestations

This cystic neoplasm is characterized by an asymptomatic course .

Most often, such neoplasms are detected during a patient examination for neurological pathologies with similar symptoms.

The clinical signs of the cyst are nonspecific; their severity depends on the size of the tumor and its location. Patients may complain of general cerebral symptoms, which are associated with compression of brain areas. A focal clinical picture is observed in rare cases, and is most often caused by the presence of hygroma or rupture of the cystic cavity.

The main features are:

1. dizziness , which are not associated with pregnancy, taking certain medications, severe fatigue, iron deficiency, and so on;
2. vomiting , which is also not associated with gastrointestinal poisoning, taking medications, and so on;
3. mental disorders, hallucinations ;
4. convulsive syndrome;
5. loss of consciousness;
6. hemiparesis , decreased sensitivity in the limbs;
7. failure to coordinate the activity of the body muscles;
8. headaches that are not relieved by painkillers;
9. a feeling of fullness , pressure, compression and increased pulsation in the affected area;
10. visual and hearing problems;
11. extraneous sounds in the ears;
12. heaviness in the skull;
13. painful or uncomfortable sensations when turning the head.

Reference! Secondary arachnoid cystic neoplasms may be accompanied by symptoms of injury or primary disease, which served as an impetus for the development of the disease.

Characteristics by location

The cyst in question may be located:

• in the temporal lobes;
• in the parietal part;
• in the frontal region;
• in the region of the cerebellum;
• in the spinal canal;
• in the spinal column;
• in the lumbar region.

In the posterior cranial fossa

This cyst in the posterior cranial fossa (posterior cranial fossa) is accompanied by symptoms:

1. persistent headaches;
2. vomit;
3. failure to coordinate movements;
4. intermittent paralysis of body parts;
5. convulsive syndrome;
6. mental disorders;
7. hallucinations.

According to statistics, tumors of this type are more often observed in men, in addition, the increase in the volume of the cystic cavity in men occurs more actively than in women. With a very large cyst, speech defects, hearing loss, and temporary memory problems may occur.

In the sacral canal

An arachnoid type cyst in the sacral region is a cavity. In it, the spinal membrane forms web-like walls. If the cyst size is more than 1.5 cm, the patient may complain of:

1. lower back pain with increased loads;
2. numbness, paresis, impaired functionality of the limbs;
3. headaches, blood pressure surges, dizziness;
4. if the cyst is located at the S2 level, sexual function is impaired, and intestinal problems also arise.

In the temporal lobe

A cyst in the temporal lobe is most often observed on the left side. This is due to the more delicate structure of the left-sided meninges and their increased sensitivity to infections. A person with a cyst in this area experiences:

1. unsteady gait;
2. lack of motor coordination;
3. deterioration of sensitivity of the limbs;
4. convulsions;
5. blackouts;
6. mental disorders.

These symptoms are caused by hydrocephalus - the accumulation of fluid in the skull. A cyst of the right frontal lobe is accompanied by a similar clinical picture.

Traditional methods of treating cysts

If doctors, after diagnosis, reveal that the patient has an inoperable type of brain cyst, it’s time to use folk remedies to combat the pathology. Infusions and decoctions of medicinal herbs will help with this. Hemlock, from which the oil solution is prepared, promotes the resorption of the first manifestations of cyst formation. This solution is also good as a prophylactic agent. To prepare, you need to take 1 part of crushed seeds or grass stems, pour in 500 ml of olive oil. The solution is infused in a dark place for three weeks. The oil is filtered using gauze and taken through the nose three times a day.

The same solution can also be used in an incremental manner. First, take 1 drop and increase to 40, then decrease from 40 to 1. The course will last 80 days. If necessary, you can repeat it in a month. Caucasian dioscorea root (4 pieces) is infused in 700 ml of vodka for a week. Then the tincture is drained and 700 ml of new vodka is poured. Leave for 5 days. Strain, take 1 tsp before meals three times a day.

Elecampane has been used as an excellent anti-cystic remedy for many years. To prepare medicine from this herb you need 1 tbsp. l. baker's yeast, pour 3 liters of boiled warm water and add 40 g of dried elecampane. All components are mixed and left for two days in a dark place. Take the infusion 4 times a day, half a glass, for three weeks.

An excellent preventative against the formation of brain cysts is burdock juice, which is diluted in a glass of boiled water in the proportion of 1 tsp. per glass and drink 2 times a day.

Today, an arachnoid cyst is a disease that rapidly progresses, sparing neither adults nor children. Timely diagnosis, tolerance and care for relatives suffering from the disease can be an excellent preventative measure and protection against it. Young women who want to find the happiness of motherhood must understand that this is a serious step into the future, and the health of the baby is a big priority. Any deviation from the norm during pregnancy should be the reason for visiting a doctor.

Brain cyst

- This is, as a rule, a benign pathological formation filled with cerebrospinal fluid (CSF). Such formations are divided depending on their location. In the case of a retrocerebellar arachnoid cerebrospinal fluid cyst of the brain, we are talking about a formation that simultaneously affects the arachnoid meninges, as well as the gray matter, i.e. nerve cells. Also, when classifying the disease, a more precise area of ​​the cyst may be indicated (for example, arachnoid retrocerebellar cyst of the posterior cranial fossa, lower, upper cyst).

The formation of this type of cyst is preceded by necrotic phenomena - death of gray matter. This may be due to infectious and inflammatory diseases of the brain, injuries, and some other factors. If the formation is small, it may not manifest itself and may be discovered by chance during diagnostic studies. In such cases, it is usually recommended to simply monitor the dynamics of the development of the cyst; treatment is not carried out. Let’s look at how a retrocerebellar arachnoid cyst of the brain can be dangerous.

What sizes of retrocerebellar arachnoid cyst are dangerous?

Like other types of brain cysts, this type is dangerous when it increases in size, especially rapidly. At the same time, there are no general trends regarding the likelihood of growth of brain cysts and the speed of this process, so it is impossible to predict with certainty the further “behavior” of the formation. There is also a danger of rupture and suppuration of the cyst.

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Brain arachnoiditis most often occurs against the background of viral or bacterial infections and is an autoimmune inflammation of the arachnoid membranes of the brain. As a result of the development of the disease, adhesions and cysts appear in the lining of the brain, damage to the cranial nerve endings, and dysfunction of the cerebellum are observed. Arachnoiditis can affect not only the membranes of the brain, but also the spinal cord

. If the disease is not treated, the prognosis for the patient is disastrous: hydrocephalus develops, cerebral hernias form, and death is possible.

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:

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

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

1. migraine;
2. vomit;
3. paralysis and paresis;
4. problems with balance;
5. the image before your eyes becomes unclear;
6. decreased concentration;
7. deterioration of character;
8. loss of consciousness;
9. twitching of the eyeballs;
10. deterioration of thinking;
11. violation of orientation in space and time;
12. decreased muscle tone.

In children

In children, this neoplasm is diagnosed based on symptomatic manifestations and the child’s medical history.

The specialist will find out whether the child has had injuries or operations in the brain, whether he or she also suffered from meningitis, or whether there have been hemorrhages.

After this, a neurological examination is performed, and a CT or MRI is also prescribed.

It must be said that this pathology is dangerous for the child. It consists in provoking persistent neurological disorders and epileptic seizures.

Under no circumstances should parents independently treat their child, much less let the disease take its course. The baby urgently needs to be shown to a doctor who will prescribe the correct treatment regimen. If the clinical picture is pronounced, surgical intervention may be required.

Clinical picture in a newborn baby:

1. strong pulsation in the fontanel region;
2. limbs are flaccid;
3. unoriented look.

One of the clearest signs of a cyst in a newborn is severe regurgitation during or after feeding.

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Diagnosis and treatment

Diagnosis consists of CT or MRI.

Based on the results of these studies, it is possible to accurately determine the presence of a cyst, its size and location.

Since the cyst is considered a consequence of other pathologies, the following is prescribed:

1. blood test to detect viruses, infections and autoimmune pathologies;
2. prothrombin index;
3. blood test for cholesterol levels;
4. Doppler of cerebral vessels;
5. ECG;
6. monitoring blood pressure.

Small and medium cysts are treated conservatively and are prescribed:

1. drugs that resolve adhesions - Longidaza, Karipatin;
2. means that improve metabolic processes - Gliatilin, Actovegin;
3. immunomodulators – Thymogen, Viferon;
4. antiviral agents – Amiksin, Pyrogenal.

Complicated cysts, as well as large cysts that provoke an acute clinical picture, are removed surgically. This is, as a rule, an endoscopic intervention - piercing the wall of a cystic neoplasm and pumping out liquid contents from it. If such an operation is impossible, bypass surgery or microneurosurgery is performed.

Treatment with folk remedies

The use of traditional medicine for brain cysts only has a supporting effect, so I use them only when the pathology is asymptomatic. Most often used:

1. hemlock;
2. Caucasian Dioscorea;
3. yeast elixir.

You must understand that it is impossible to cure pathology using traditional methods; they are aimed at cleansing and dilating the blood vessels of the brain, stopping inflammation and having a positive effect on brain function.

Drug treatment of lacunar cyst

You need to understand that if a patient was diagnosed with a cyst that developed during the period of intrauterine growth, then it is most likely a hereditary disease. It is impossible to insure yourself against this type of tumor.

If the cyst is diagnosed as an acquired pathology, this means that it was the result of some kind of somatic disease. For example, it appeared as a complication after meningitis or traumatic brain injury. Diabetes mellitus, thrombosis, and hypertension can lead to the appearance of a cyst.

Often, frequent concussions can cause the appearance of a tumor in the brain. This phenomenon occurs in professional sports, where an athlete often receives traumatic brain injuries, for example, boxing or other martial arts.

Post-ischemic lacunar cyst has become widely known in medical circles. From the name it is clear that it was a consequence of ischemic brain disease, which, in fact, leads to chronic hypertension.

Postischemic lacunar cysts of the brain are studied and treated simultaneously with stroke. Often they become the cause of craniotomy and brain surgery. But lacunar cerebrospinal fluid cyst is amenable to radiation therapy, and surgery in this case is not always required.

If the cyst does not bother the patient, does not increase in size and does not pose a danger, then it is not subject to special treatment. In this case, therapy is aimed at eliminating the cause of its occurrence.

For example, if a patient has suffered a severe viral disease such as meningitis or encephalitis, then he is treated with antibiotics and immune-strengthening drugs. The specific type of drug, its dosage and regimen of use are prescribed individually depending on the general condition of the patient.

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%.

Symptoms of a brain cyst

In most cases, in the presence of a congenital cyst, a person does not develop symptoms throughout his life. As a rule, there is no oncological risk with such formations either.

If the formation increases, this leads to an increase in intracranial pressure, eventually developing the following symptoms:

• Headache.
• Weakness and deterioration in performance.
• Insomnia.
• Pressure in the eye area.
• Hallucinations.
• Spasms of the limbs and face.
• Nausea and vomiting.

Speaking about the dangers of a cyst in the head, it is necessary to take into account that such formations sometimes quickly increase in size. If a cyst of the transparent septum of the brain and other types of such formations increase in size, this leads to the degradation of certain brain structures, as a result of which the cells lose their functions.

The consequences of a cyst in the head of a newborn are sometimes manifested by delayed psychomotor development. The consequences depend on which part of the brain is affected by the education. Thus, a newborn may have problems with motor activity, a child or an adult may experience speech disorders, tremors , paresis , etc. Cystic-glial changes can lead to the development of the symptoms described above, as well as to the appearance of problems with hearing, vision, memory, etc.

But in general, it is possible to clearly say what is dangerous about a retrocerebellar arachnoid cyst of the brain, or what threatens a pineal gland cyst only after a comprehensive examination and a specialist’s opinion.

Sometimes this condition may be accompanied by other disorders (coelomic pericardial cyst, etc.).