1/12. Giant spinal arachnoid cysts: computed tomography, magnetic resonance imaging and magnetic resonance myelography correlation.Two cases of giant spinal arachnoid cysts, one of them being symptomatic, are discussed, along with their CT, MRI and MR myelography findings.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/12. Giant congenital melanocytic naevus and symptomatic thoracic arachnoid cyst.A 43-year-old female with multiple congenital naevi presented with a 5-year history of right upper quadrant pain. magnetic resonance imaging demonstrated a large epidural thoracic arachnoid cyst. This case highlights the need to consider that the management of patients with giant congenital melanocytic naevus is variable depending on the age of the patient, the location of lesions and the presence of complications such as neurocutaneous melanosis. The value of magnetic resonance scanning as a screening device is discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/12. Spinal compression caused by multiple arachnoidal cyst.A 14-year-old boy presented with subacute onset of paraparesis. The spinal compression was due to multiple giant sized spinal arachnoid cysts. Postoperatively the patient recovered completely.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/12. Giant anterior cervicothoracic arachnoid cyst.STUDY DESIGN: A case report with a review of the literature is presented demonstrating the imaging findings of a patient with recent onset, progressive spinal cord compression at T6 caused by a giant arachnoid cyst that was successfully treated. OBJECTIVE: To present the imaging findings of a giant anterior cervicothoracic intradural arachnoid cyst using several methods before and after treatment. SUMMARY OF BACKGROUND DATA: This case demonstrates the imaging findings of the largest described anterior cervical arachnoid cyst straddling the cervicothoracic junction. It presented with spinal cord compression in a 26-year-old diagnosed by MRI and successfully treated surgically. methods: The patient experienced progressive left-sided sensory and motor deficits below T6. pain and temperature sensation were decreased. Reflexes were increased in both lower extremities with clonus. Preoperative MRI was followed by laminectomy and cyst fenestration with subsequent postoperative myelogram and CT. RESULTS: Imaging confirmed the presence of a giant arachnoid cyst straddling the cervicothoracic junction. Postoperative imaging documented relief of spinal cord compression. Symptoms improved progressively after surgery. By the time of discharge all residual neurologic deficits had resolved. CONCLUSION: Anterior arachnoid cysts straddling the cervicothoracic junction have yet to be reported, and arachnoid cysts involving the cervical region are extremely rare. Imaging demonstrated the cyst and its response to treatment. This patient responded well to surgery and was discharged without neurologic sequelae.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
5/12. Chronic subdural hemorrhage into a giant arachnoidal cyst (Galassi classification type III).The authors present CT and MRI of a patient with an extremely large arachnoidal cyst (Galassi classification type III). The cyst extended from the base of the skull, posterior to the brain stem, on the base of the temporal lobe over the complete convexity of the left hemisphere. The cyst consisted of multiple compartments with intracystic septa and was accompanied by a chronic subdural hemorrhage in the compartments. After contrast agent application, the typical characteristics of chronic subdural membranes were found. Besides bony deformities, a thinning of the inner table was found. The patient underwent craniotomy for evacuation of the hemorrhage and fenestration of the septa while he was free of symptoms. This is a remarkable case proving that chronic local intracranial pressure does not inevitably lead to neurologic symptoms or intellectual disabilities.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
6/12. Giant supratentorial enterogenous cyst: report of a case, literature review, and discussion of pathogenesis.OBJECTIVE AND IMPORTANCE: To describe a histologically well-documented adult case of a giant supratentorial enterogenous cyst (EC). Fewer than 15 cases of supratentorial ECs are on record: 8 associated with the brain hemispheres or the overlying meninges, 4 with the sellar region, and 2 with the optic nerve. CLINICAL PRESENTATION: A 31-year-old woman complained of long-standing mild left brachial and crural motor deficit precipitated by headache and signs of intracranial hypertension. magnetic resonance imaging revealed a huge cyst overlying the frontoparietal brain. INTERVENTION: Symptoms were relieved by evacuation of the cyst content by means of a Rickam's reservoir, and the lesion was subsequently removed in toto. Histological and immunohistochemical examination of the cyst wall clearly established the enterogenous nature of its epithelium. Follow-up for up to 2 years after intervention showed no sign of recurrence, and symptoms, including treatment-resistant seizures in the postoperative period, have entirely subsided. CONCLUSION: Supratentorial ECs, distinctly rare in adult patients, may in some cases present as giant lesions. Total removal seems to be curative once careful examination has eliminated the possibility of a metastasis from an unknown primary. A correct histological diagnosis is important because, in contrast to other benign cysts of similar location and size, ECs may be prone to intraoperative dissemination.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
7/12. Detection of a dural defect by cinematic magnetic resonance imaging and its selective closure as a treatment for a spinal extradural arachnoid cyst.STUDY DESIGN: We document a giant spinal extradural arachnoid cyst treated by selective closure of the dural defect. It was diagnosed using cinematic magnetic resonance imaging (cine-MRI). OBJECTIVE: To demonstrate the effectiveness of selective closure of the dural defect as a treatment for a spinal extradural arachnoid cyst. SUMMARY OF BACKGROUND DATA: The standard treatment for a spinal extradural arachnoid cyst is total resection of the cyst wall, if possible, and the closure of the communication site, if any, between the cyst and the subarachnoid space, after an extensive laminectomy. To our knowledge, selective closure of the dural defect through minimal laminotomy with little cyst resection has not been reported. methods: A 29-year-old woman presented with right leg muscle weakness and was diagnosed with an extradural arachnoid cyst ranging from spinal regions T11 to L3 using MRI. myelography demonstrated that the cyst communicated with the subarachnoid space. Cine-MRI showed a pulsating flow voiding on the left side of level L1, suggesting the location of the communication site. Fenestration of the T12-L1 region was performed, preserving the spinous processes and the facet joints. A small dural rent was found on the left side of level L1. This was closed using small clips. RESULTS: MRI 12 days later demonstrated that the cyst had shrunk dramatically. It had disappeared completely by 4 months. The patient's muscle weakness improved gradually, and she was almost complaint-free 6 months after the operation. CONCLUSIONS: Selective closure of the dural defect based on cine-MRI will be useful for treating extradural arachnoid cysts.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/12. Giant intrasellar arachnoid cyst manifesting as adrenal insufficiency due to hypothalamic dysfunction--case report--.A 67-year-old man first noticed loss of pubic and axillary hair in 1992 and then a visual field defect in 2001. He experienced loss of consciousness attributed to hyponatremia in April 2002. magnetic resonance imaging showed a giant intrasellar cystic mass, 40 mm in diameter, that had compressed the optic chiasm. The patient complained of chronic headache, and neurological examination revealed bitemporal hemianopsia. Preoperative endocrinological examination indicated adrenal insufficiency, and hypothyroidism due to hypothalamic dysfunction. The patient underwent endonasal transsphenoidal surgery. The cyst membrane was opened and serous fluid was drained. Histological examination identified the excised cyst membrane as arachnoid membrane. The patient's headaches resolved postoperatively, but the bitemporal hemianopsia and endocrinological function were unchanged. This arachnoid cyst associated with hypothalamic dysfunction might have been caused by an inflammatory episode in the suprasellar region.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/12. Middle cranial fossa arachnoid cysts causing sensorineural hearing loss.Arachnoid cyst of the middle cranial fossa has never been reported to present with sensorineural hearing impairment. We report the case of a 15-year-old girl who complained of progressive hearing loss on the right side for 4 years. The pure tone audiometry revealed sensorineural hearing loss with an average of 63 dB, and the auditory brain stem response demonstrated absence of all waves on the right side. magnetic resonance imaging showed giant arachnoid cysts occupying the bilateral middle cranial fossa and extending to the parietal and prepontine areas with the atrophic change of the right facial-acoustic nerve cord and a decrease in signal intensity of the right cochlea and vestibule. The cystoperitoneal shunting procedure was suggested, but the parents hesitated about the surgical treatment. The patient has not received any surgical intervention, and her hearing has been stable for 1 year during the follow-up period. This case represents the first report that sensorineural hearing loss is a possible presenting symptom when arachnoid cysts of the middle cranial fossa are massive.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/12. Idiopathic hypogonadotrophic hypogonadism associated with arachnoid cyst of the middle fossa and forebrain anomalies: presentation of an unusual case.We report a 22-yr-old male patient with hypogonadotrophic hypogonadism (HH) associated with a giant middle fossa arachnoid cyst (AC) diagnosed by magnetic resonance imaging (MRI). He presented with pubertal and growth delay. He also had learning disabilities and anosmia. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Cranial MRI showed an AC in left middle fossa with expansion to suprasellar cisterna and several abnormalities like left temporal lobe hypoplasia, left optic tract and bilateral olfactory bulb hypoplasia and left hypothalamic hypoplasia.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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