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Large Parenchymal Perianeurysmal Cyst: A Case Report
Gyani J S Birua1, Gaurav Tyagi1, Manish Beniwal1
1Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Journal of Neurosciences in Rural Practice
|November 5, 2021
Summary
Parenchymal perianeurysmal cysts, though rare, present as cystic brain lesions with mural nodules. This case highlights their importance in differential diagnosis for complex brain tumors.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Parenchymal perianeurysmal cysts are uncommon intracranial lesions.
- Differentiating these cysts from intra-axial tumors is clinically significant.
Observation:
- A 50-year-old woman presented with chronic headaches and vomiting.
- Brain MRI revealed a large cystic lesion with a cortically based mural nodule in the right basifrontal region.
- The mural nodule showed intense contrast enhancement without diffusion restriction.
Findings:
- The lesion was diagnosed as a parenchymal perianeurysmal cyst.
- Surgical intervention involved subtotal excision of the cyst and clipping of a thrombosed middle cerebral artery aneurysm.
- The patient recovered well with no neurological deficits.
Implications:
- Parenchymal perianeurysmal cysts should be considered in the differential diagnosis of cystic brain lesions with mural nodules.
- Multimodality imaging and surgical expertise are crucial for accurate diagnosis and management.
- This case underscores the importance of considering rare entities in neurosurgical practice.
