Abstract
A 53 years-old male, diagnosed with ulcerative colitis and liver cirrhosis due to HCV infection, was hospitalized at the Gastroenterology Department for paraclinical workup, prior to inclusion on the liver transplantation waiting list. The patient was known with a gigantic arachnoid cyst and presented a transient ischemic attack one year prior, for which treatment with aspirin was initiated. Consequently, we performed a brain MRI examination, which disclosed a left-sided gigantic arachnoid cyst with mass effect, midline shift of 9 mm and subfalcine herniation. No focal neurologic deficits or signs of increased intracranial pressure were found on neurological examination. Following neurosurgical evaluation, the presence of the cyst was not deemed to be a contraindication for liver transplantation.
Highlights
Arachnoid cysts are CSF-filled lesions, usually congenital in nature [1], consisting of duplications or splitings of the arachnoid layer [2].In approximately half of cases, they are found in the vicinity of the sylvian fissure [3], i.e. in the middle cranial fossa
We present the case of a 53 years-old male with liver cirrhosis due to HCV infection, who came to the Gastroenterology Department for paraclinical workup prior to inclusion on the liver transplantation waiting list
It should be noted that arachnoid cysts are common lesions, usually found incidentally during imaging procedures, and the vast majority of them are asymptomatic
Summary
Arachnoid cysts are CSF-filled lesions, usually congenital in nature [1], consisting of duplications or splitings of the arachnoid layer [2]. In approximately half of cases, they are found in the vicinity of the sylvian fissure [3], i.e. in the middle cranial fossa. They have been described in many other locations, e.g. in the sellar or suprasellar regions (near the third ventricle), quadrigeminal cistern, near the midline of the brain (parasagittal) or interhemispheric, over the cerebral convexities, or in the posterior fossa [4,5]. Three mechanisms have been proposed to explain the progressive enlargement of arachnoid cysts over time: (a) secretion of fluid by ependymal cells, (b) accumulation of fluid through an osmotic mechanism, (c) trapping of fluid through a ball-valve mechanism [6]
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