Arachnoid Cysts: Treatment, Growth, and Symptoms Explained

MRI of the brain revealed the presence of a cyst?

Hello Doctor,
I had a brain MRI at the end of March, and the report indicated a suspected arachnoid cyst or mega cisterna magna in the posterior fossa of the cerebellar tonsils.

1.
What treatment options are available for this condition?
2.
Is there a possibility that it will continue to grow? If so, at what rate?
3.
Will this condition affect sensory perception, balance, appetite, or cause dizziness?
4.
Should I consult a neurosurgeon for further follow-up?
I look forward to your response.
Thank you!

Wei, 40~49 year old female. Ask Date: 2022/06/09

Dr. Lai Zhaokang reply Neurosurgery

1.
Arachnoid cysts are generally asymptomatic.
When symptoms do occur, they can vary from person to person.
They may include headaches, dizziness, nausea, vomiting, or seizures.
Other symptoms depend on the location of the cyst and its pressure on the spinal cord or brain.
These may include vision, hearing, motor, and balance issues, developmental delays, behavioral changes, and endocrine system effects related to puberty and sexual development.
Symptoms such as numbness and tingling in the limbs, muscle spasms, and movement problems may also occur.

Most cysts do not require further treatment.
If a cyst is large, growing, or causing symptoms, treatment may be recommended.
This could include endoscopic fenestration, craniotomy, shunting (such as cyst-peritoneal shunt), or surgical resection.

2.
Cysts may enlarge, typically at a slow rate, but there are no statistical studies to confirm this.
Generally, growth is measured in years.

3.
The symptoms documented in the literature are as mentioned above.

4.
The vast majority of cysts do not cause symptoms and are often discovered incidentally during brain imaging.
If there are no significant corresponding symptoms, surgery is not necessary.
If there are concerns, follow-up with a neurosurgeon can be scheduled every 3, 6, or 12 months.

Best wishes,
Dr.
Lai Chao-Kang, Neurosurgery, Changhua Hospital

Reply Date: 2022/06/09

More Info

Arachnoid cysts are fluid-filled sacs that occur in the arachnoid membrane, one of the three membranes that cover the brain and spinal cord. They can be congenital (present at birth) or acquired due to injury, infection, or other conditions. Understanding the implications of an arachnoid cyst, including its treatment options, growth potential, and associated symptoms, is crucial for managing your health.

1. Treatment Options: The treatment for an arachnoid cyst largely depends on its size, location, and whether it is causing symptoms. If the cyst is small and asymptomatic, it may simply be monitored over time with regular MRI scans to check for any changes. However, if the cyst is large or causing symptoms such as headaches, seizures, or neurological deficits, surgical intervention may be necessary. The most common surgical procedures include:
- Cystoperitoneal Shunt: This involves placing a tube to drain the fluid from the cyst into the abdominal cavity, where it can be absorbed by the body.

- Endoscopic Cyst Fenestration: This minimally invasive procedure involves creating an opening in the cyst to allow the fluid to drain and reduce pressure on surrounding structures.

- Open Surgery: In some cases, a more invasive approach may be required to remove the cyst entirely.

2. Growth Potential: Arachnoid cysts can vary in their growth patterns. Some cysts remain stable in size, while others may grow over time. The rate of growth can be unpredictable and may depend on factors such as the cyst's location and the individual’s anatomy. Regular follow-up with MRI scans is essential to monitor any changes in size or characteristics of the cyst.

3. Symptoms and Effects: Arachnoid cysts can potentially affect various neurological functions, depending on their size and location. Common symptoms may include:
- Headaches: These can range from mild to severe and may be persistent.

- Balance Issues: If the cyst is located near the cerebellum, it may affect coordination and balance.

- Sensory Changes: Some individuals may experience altered sensations or numbness.

- Dizziness or Vertigo: This can occur if the cyst affects the inner ear structures or the brain regions responsible for balance.

- Seizures: In some cases, cysts can irritate the surrounding brain tissue, leading to seizure activity.

- Cognitive Changes: Although less common, some individuals may experience changes in memory or cognitive function.

4. Consulting a Neurosurgeon: Given the findings from your MRI and the potential for symptoms, it is advisable to consult a neurosurgeon for further evaluation. They can provide a comprehensive assessment of your condition, discuss the risks and benefits of potential treatments, and determine the best course of action based on your specific situation. Regular follow-up with a healthcare provider is crucial to ensure that any changes in your condition are promptly addressed.

In summary, while arachnoid cysts can be concerning, many individuals live with them without significant issues. Monitoring and appropriate management can help mitigate potential complications. If you experience any new or worsening symptoms, it is essential to seek medical attention promptly.

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