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Asymptomatic giant arachnoid cyst.

Fabrice Hubele1, Alessio Imperiale, Stéphane Kremer

  • 1Service de Biophysique et Médecine Nucléaire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Clinical Nuclear Medicine
|September 8, 2012
PubMed
Summary
This summary is machine-generated.

A large arachnoid cyst in the frontal lobe was incidentally found in a patient undergoing PET/CT. Brain MRI revealed significant cortical reorganization in motor areas, suggesting brain plasticity.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Neurosurgery

Background:

  • Positron Emission Tomography/Computed Tomography (FDG PET/CT) is utilized for diagnosing various conditions, including sarcoidosis.
  • Incidental findings during diagnostic imaging can reveal unexpected neurological conditions.

Observation:

  • A 51-year-old male bricklayer, initially evaluated for suspected mediastinal sarcoidosis, underwent a whole-body FDG PET/CT scan.
  • The scan incidentally identified a large right frontal arachnoid cyst.
  • Magnetic Resonance Imaging (MRI) confirmed the cyst's mass effect, causing compression of adjacent cerebral parenchyma and sulci.

Findings:

  • Despite significant mass effect from the arachnoid cyst, the adjacent cerebral cortex showed normal glucose metabolism on FDG PET/CT.
  • Functional MRI, using a finger-thumb paradigm, demonstrated a notable reorganization of motor cortex activation within the right cerebral hemisphere.
  • This reorganization showed increased activation between the inferior frontal gyrus and the postcentral gyrus.

Implications:

  • This case highlights the potential for incidental findings of arachnoid cysts during oncologic or inflammatory imaging.
  • The observed cortical reorganization suggests significant brain plasticity and functional adaptation in response to chronic mass effect from an arachnoid cyst.
  • Further research into functional brain reorganization in patients with asymptomatic intracranial cysts is warranted.