Acquired mirror-image cerebellopontine angle arachnoid cysts: case report
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1Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.
Insights
This study documents acquired arachnoid cysts in a child after brain surgery, challenging the congenital origin theory. These posterior fossa cysts highlight the need to consider acquired causes in neurosurgical cases.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Radiology
Background:
- Arachnoid cysts are typically congenital neurosurgical findings.
- A subset of arachnoid cysts may be acquired, developing post-intervention.
- Posterior fossa arachnoid cysts require careful diagnostic consideration.
Observation:
- A 17-month-old girl developed bilateral cerebellopontine angle arachnoid cysts post-posterior fossa tumor surgery.
- Initial treatment involved surgical evacuation and cyst wall excision for a left-sided cyst.
- A subsequent right-sided cyst was managed with a cystoperitoneal shunt.
Findings:
- Radiological evidence confirmed the acquired nature of these cerebellopontine angle arachnoid cysts.
- The case demonstrates the development of arachnoid cysts following neurosurgery.
- Acquired arachnoid cysts can occur in the posterior fossa.
Implications:
- This case challenges the exclusively congenital view of arachnoid cysts.
- It emphasizes the importance of considering acquired etiologies in posterior fossa cyst development.
- Understanding acquired arachnoid cysts is crucial for appropriate neurosurgical management and patient care.
Abstract:
Arachnoid cysts are neurosurgical entities that have long been considered to be congenital in origin. Many examples in the literature suggest that there is a subgroup of arachnoid cysts that are required. The authors present the clinical history of a 17-month-old girl who developed two cerebellopontine angle arachnoid cysts after posterior fossa surgery for a brain tumor. After surgical excision of the tumor the child developed a left cerebellopontine angle cyst. This was treated through a suboccipital craniectomy by evacuating the cyst and excising the cyst wall. Two months later the child developed a second right-sided cerebellopontine angle cyst. It was treated by inserting a cystoperitoneal shunt. This article presents the case with radiological evidence of the acquired nature of the cysts. It also includes a brief review of the clinical presentation, pathogenesis, radiological evaluation, and surgical treatment of arachnoid cysts with emphasis on those occurring in the posterior fossa.