Abstract
BackgroundIntracranial arachnoid cysts are collections of cerebrospinal fluid within the arachnoid membrane and subarachnoid space of the cisterns and major cerebral fissures that account for about 1% of all intracranial lesions. Expansion of the cyst and compression on surrounding structures may became symptomatic, which reflects its size and anatomic distribution.Case presentationHere, we present a very rare case of patient with supratentorial intraparenchymal arachnoid cyst placed in the left frontal lobe without any communication with the subarachnoid space and ventricle and presented with clinical symptoms. The patient underwent fenestration of the lesion and was clinically improved.ConclusionsAlthough the etiology and the enlargement mechanism of arachnoid cysts remain unclear, both conservative and surgical treatments are optional. According to size, anatomical location, neuroimaging, and clinical symptoms, an arachnoid cyst should be included in the differential diagnosis of primary intracerebral cysts.
Highlights
ConclusionsThe etiology and the enlargement mechanism of arachnoid cysts remain unclear, both conservative and surgical treatments are optional
We present a case of an arachnoid cyst arising in the left frontal lobe without any communication with the subarachnoid space and ventricle
Arachnoid cyst is lined by flat or cuboidal cells overlying the fibrous connective tissue, unlike neurenteric cysts which are covered with simple to pseudostratified epithelium, epidermoid/dermoid cysts with keratinizing epithelium, or ependymal cysts in which case a basement membrane on the epithelial lining, which is present in arachnoid cysts, lacks [1, 4, 9,10,11]
Summary
The primary intracerebral cysts include ependymal, neurenteric, and epidermoid/dermoid cysts. The differential diagnosis in-between primary intracranial cysts are very important for adequate treatment Some symptomatic cysts, such as neurenteric and epidermoid/dermoid, should be properly surgically removed, including both cystic wall and content to avoid recurrences [9, 10]. Most of the arachnoid cysts remain constant through life; their enlargement cannot be explained with previously described theories, such as active CSF secretion from walls of the cysts, osmotic gradient between cystic content and CSF caused by a higher protein concentration in the cyst fluid, or cyst contents communicating with the subarachnoid space via ball-valve mechanisms that entrap CSF during Valsalva maneuvers [2, 17,18,19].
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