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Liang ES, Efendy M, Winter C, Coulthard A. Intracranial perianeurysmal cysts: case series and review of the literature. J Neurointerv Surg 2021; 14:837-841. [PMID: 34380710 DOI: 10.1136/neurintsurg-2021-017807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/31/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Intracranial perianeurysmal cysts are a rare finding associated with cerebral aneurysms. Patients may present with symptoms secondary to mass effect from perianeurysmal cysts requiring drainage. These lesions can masquerade as neoplasms if dedicated vascular imaging is not performed, leading to misdiagnosis. METHOD A retrospective search of our database was done for intracranial aneurysms that have been treated between 1998 and 2020. A literature search was then performed on PubMed and Google Scholar with the search terms 'aneurysm', 'intracranial/intracerebral', 'cyst', and 'perianeurysmal cyst'. Patient demographics, aneurysms and cysts characteristics were then summarized as a table and in the discussion. RESULTS Three cases where intracranial aneurysm had associated perianeurysmal cysts were found in our database. Combined with the available literature a total of 19 cases of perianeurysmal cysts have thus far been reported since this entity was first described in 2002. A significant number of perianeurysmal cysts (5/19) required intervention. In 5/19 cases the patient presented with a perianeurysmal cyst without a history of subarachnoid hemorrhage. Of the 10 cases where aneurysm follow-up was reported there were 5 cases where there was aneurysm recurrence necessitating re-treatment. CONCLUSION Significant variability exists in the patient demographics, aneurysm and cyst characteristics of perianeurysmal cysts. This suggests that there is no single unified etiology and pathogenesis. These lesions are a rare finding and at present do not appear to carry diagnostic or prognostic significance. Management of perianeurysmal cysts is case-dependent and intervention should be considered when treating the related aneurysm, especially in patients with secondary symptoms.
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Affiliation(s)
- Ee Shern Liang
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | | | - Craig Winter
- Department of Neurosurgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alan Coulthard
- Department of Medical Imaging, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
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de Aguiar GB, dos Santos RG, Paiva ALC, Silva JMDA, da Silva RC, Veiga JCE. Intracranial aneurysm and arachnoid cyst: just a coincidence? A case report. SAO PAULO MED J 2019; 137:92-95. [PMID: 29267534 PMCID: PMC9721213 DOI: 10.1590/1516-3180.2017.0083290517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/29/2017] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Presence of an arachnoid cyst and a non-ruptured intracystic brain aneurysm is extremely rare. The aim of this paper was to describe a case of a patient with an arachnoid cyst and a non-ruptured aneurysm inside it. Clinical, surgical and radiological data were analyzed and the literature was reviewed. CASE REPORT A patient complained of chronic headache. She was diagnosed as having a temporal arachnoid cyst and a non-ruptured middle cerebral artery aneurysm inside it. Surgery was performed to clip the aneurysm and fenestrate the cyst. CONCLUSIONS This report raises awareness about the importance of intracranial vascular investigation in patients with arachnoid cysts and brain hemorrhage.
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Affiliation(s)
- Guilherme Brasileiro de Aguiar
- MD, MSc. Attending Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo (SP), Brazil.
| | - Rafael Gomes dos Santos
- Medical Student, Faculdade de Medicina da Santa Casa de São Paulo (FMSCSP), São Paulo (SP), Brazil.
| | - Aline Lariessy Campos Paiva
- MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo (SP), Brazil.
| | - João Miguel de Almeida Silva
- MD. Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), and Endovascular Neurosurgery Fellow, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo (SP), Brazil.
| | - Rafael Carlos da Silva
- MD. Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo (SP), Brazil.
| | - José Carlos Esteves Veiga
- MD, PhD. Full Professor and Head of Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FMSCSP), São Paulo (SP), Brazil.
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Kode S, Hegde A, Menon G. Chronic Subdural Hematoma Associated with Congenital Arachnoid Cysts: Management Dilemmas. Cureus 2018; 10:e2550. [PMID: 29974007 PMCID: PMC6029743 DOI: 10.7759/cureus.2550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Chronic subdural hematoma (CSDH) is one of the commonest diseases encountered by a neurosurgeon in daily practice. It is however rarely seen in young patients. Congenital arachnoid cysts have been implicated in both traumatic and spontaneous CSDH in young individuals. Optimum treatment strategies to address the CSDH and arachnoid cyst are not very well described. We report a young gentleman who was treated for a CSDH with arachnoid cysts, two months after a mild head injury. The patient was operated with a simple burr hole drainage of hematoma with a drain. He was discharged with no further need to address the arachnoid cyst. CSDH associated with arachnoid cysts can be treated with simple burr hole drainage. Craniotomy, fenestration and cerebrospinal fluid (CSF) diversion should be reserved only as secondary procedures.
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Affiliation(s)
- Sashanka Kode
- Neurosurgery, Kasturba Medical College, Manipal 576104, Karnataka, India
| | - Ajay Hegde
- Neurosurgery, Kasturba Medical College, Manipal 576104, Karnataka, India
| | - Girish Menon
- Neurosurgery, Kasturba Medical College, Manipal 576104, Karnataka, India
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Igarashi Y, Murai Y, Yamada O, Shirokane K, Hironaka K, Sato S, Sugiyama M, Tachizawa T, Morita A. Cerebral Aneurysm Associated with an Arachnoid Cyst: 3 Case Reports and a Systematic Review of the Literature. World Neurosurg 2017; 109:e203-e209. [PMID: 28964944 DOI: 10.1016/j.wneu.2017.09.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Arachnoid cysts and intracranial aneurysms are not rare, but it is unusual for an aneurysm to be associated with an arachnoid cyst. The objective of this study was to reveal the association between arachnoid cysts and intracranial aneurysms. METHODS Methods included to report 3 cases with these 2 pathologies and to perform a systematic review of the English and Japanese literature using PubMed, Scopus, and Ichushi Web. RESULTS The first case was of a 46-year-old man with a subarachnoid hemorrhage on the basal cistern and bilateral arachnoid cysts in the middle fossa, the second was that of a 29-year-old woman with a subarachnoid hemorrhage at the basal cistern and an arachnoid cyst in the left middle fossa, and the third was that of a 60-year-old man with a right putaminal hemorrhage and contralateral unruptured aneurysm and arachnoid cyst. A literature search for similar cases found 27 patients. CONCLUSIONS It was difficult to diagnose a ruptured aneurysm in some cases with an arachnoid cyst because computed tomography scan showed atypical findings, such as no hemorrhage, intracystic localized hemorrhage, or subdural hematoma. This review revealed that aneurysms and arachnoid cysts were significantly located ipsilaterally and that they occurred together in relatively young patients.
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Affiliation(s)
- Yutaka Igarashi
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan; Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
| | - Yasuo Murai
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Osamu Yamada
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | | | - Kohei Hironaka
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Shun Sato
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Makoto Sugiyama
- Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki City, Japan
| | | | - Akio Morita
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
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Krauer F, Ahmadli U, Kollias S, Bleisch J, Wüthrich RP, Serra AL, Poster D. Growth of arachnoid cysts in patients with autosomal dominant polycystic kidney disease: serial imaging and clinical relevance. Clin Kidney J 2015; 5:405-11. [PMID: 26019816 PMCID: PMC4432421 DOI: 10.1093/ckj/sfs111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 07/19/2012] [Indexed: 12/27/2022] Open
Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder that results in the growth of cysts in the kidneys and other organs. Multisystemic involvement is common including affection of the central nervous system with cerebral aneurysms and arachnoid cysts. Methods This is a prospective cohort study to investigate the prevalence and growth rate of arachnoid cysts in ADPKD patients. Participants enrolled in the SUISSE ADPKD cohort were offered cranial imaging for the detection of intracranial alterations. In the case of identified arachnoid cysts, patients were suggested to undergo follow-up imaging to assess the growth rate of the cysts. Volume of arachnoid cysts at the baseline and at follow-up visits was assessed by manual segmentation on a dedicated workstation. Results A total of 109 ADPKD patients agreed to undergo cranial imaging. In 14 (12.8%) patients (9 males and 5 females), 18 singular arachnoid cysts were identified. The baseline volumes of individual cysts ranged from 1.8 to 337.6 cm3. During a mean follow-up period of 24 months, the volume changes of 12 individual arachnoid cysts of nine patients ranged from −3.1 to 3.7 cm3. Cystic lesions were mostly localized in the middle fossa. All affected patients were clinically asymptomatic. Conclusions We found a higher prevalence of arachnoid cysts in ADPKD patients with more advanced disease. There was a large variability in size and growth. These arachnoid cysts were clinically silent and their growth pattern was subtle and unpredictable, in contrast to the much more foreseeable growth of the renal cysts.
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Affiliation(s)
- Fabienne Krauer
- Division of Nephrology , University Hospital Zurich , Zurich , Switzerland
| | - Uzeyir Ahmadli
- Division of Neuroradiology , University Hospital Zurich , Zurich , Switzerland
| | - Spyros Kollias
- Division of Neuroradiology , University Hospital Zurich , Zurich , Switzerland
| | - Jörg Bleisch
- Division of Nephrology , Hospital Zollikerberg in Zurich , Zurich , Switzerland
| | - Rudolf P Wüthrich
- Division of Nephrology , University Hospital Zurich , Zurich , Switzerland
| | - Andreas L Serra
- Division of Nephrology , University Hospital Zurich , Zurich , Switzerland
| | - Diane Poster
- Division of Nephrology , University Hospital Zurich , Zurich , Switzerland
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Choi JY, Cha SH, Cho WH, Ko JK. Communicating hydrocephalus accompanied by arachnoid cyst in aneurismal subarachnoid hemorrhage. J Cerebrovasc Endovasc Neurosurg 2013; 15:311-5. [PMID: 24729958 PMCID: PMC3983532 DOI: 10.7461/jcen.2013.15.4.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/17/2013] [Accepted: 10/31/2013] [Indexed: 11/23/2022] Open
Abstract
The authors describe a case of communicating hydrocephalus accompanied by an arachnoid cyst in an aneurismal subarachnoid hemorrhage. A 69-year-old female was referred to our clinic due to the sudden onset of a headache. A head computed tomography scan demonstrated an arachnoid cyst in the right middle fossa with a mass effect and diffuse subarachnoid hemorrhage. Digital subtraction angiography then revealed a left internal carotid-posterior communicating artery aneurysm. The neck of the aneurysm was clipped successfully and the post-operative period was uneventful. However, two months after discharge, the patient reported that her mental status had declined over previous weeks. A cranial computed tomography scan revealed an interval increase in the size of the ventricle and arachnoid cyst causing a midline shift. Simultaneous navigation guided ventriculoperitoneal shunt and cystoperitoneal shunt placement resulted in remarkable radiological and clinical improvements.
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Affiliation(s)
- Jae Young Choi
- Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seung Heon Cha
- Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Won Ho Cho
- Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jun Kyeung Ko
- Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea
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