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Khizar A, Shahzad W, Yadav PK. Galassi type III arachnoid cyst presenting as a migraine of weariness. Clin Case Rep 2023; 11:e6891. [PMID: 36698522 PMCID: PMC9860132 DOI: 10.1002/ccr3.6891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 12/04/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
A 24-year-old right-handed male presented with a 4-month history of migraine of weariness. Typical accompanying symptoms with migraine like nausea, vomiting, photophobia and aura were not present. Non-contrast CT brain revealed a left sided large frontotemporoparietal (Galassi Type III) arachnoid cyst. The patient underwent a cystoperitoneal shunt.
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Peraud A, Ibel R. Controversies in the Treatment of Arachnoid Cysts with Special Emphasis on Temporal Arachnoid Cysts. Adv Tech Stand Neurosurg 2023; 46:175-192. [PMID: 37318575 DOI: 10.1007/978-3-031-28202-7_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intracranial arachnoid cysts (ACs) are benign lesions. The incidence in children is 2.6%. ACs are often diagnosed incidentally. Because of the broad use of CT and MR imaging, the frequency of AC diagnosis has increased. In addition, prenatal diagnosis of ACs is becoming more common. This places clinicians in a difficult situation with regard to the optimal treatment, since the presenting symptoms are often vague and operative management includes not negligible risks. It is generally accepted that conservative management is indicated in cases with small and asymptomatic cysts. In contrast, patients with definite signs of raised intracranial pressure should be treated. There are however clinical situations in whom the decision about the preferred treatment is difficult to make. Unspecific symptoms such as headaches and neurocognitive or attention deficits can be challenging to evaluate, whether they are related to the presence of the AC or not. The treatment techniques intent to establish a communication between the cyst and the normal cerebrospinal spaces or consist of a diversion of the cyst fluid by a shunt system. Which surgical method (open craniotomy for cyst fenestration, endoscopic fenestration, or shunting) is preferred differs between neurosurgical centers or the pediatric neurosurgeon in charge. Each treatment option has a unique profile of advantages and disadvantages which should be considered when discussing treatment with the patients or their caregivers.
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Affiliation(s)
- Aurelia Peraud
- Section Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Ulm, Ulm, Germany.
| | - Rebecca Ibel
- Section Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Ulm, Ulm, Germany
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Ibáñez A, Zimerman M, Sedeño L, Lori N, Rapacioli M, Cardona JF, Suarez DMA, Herrera E, García AM, Manes F. Early bilateral and massive compromise of the frontal lobes. NEUROIMAGE-CLINICAL 2018; 18:543-552. [PMID: 29845003 PMCID: PMC5964834 DOI: 10.1016/j.nicl.2018.02.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/29/2018] [Accepted: 02/26/2018] [Indexed: 12/20/2022]
Abstract
The frontal lobes are one of the most complex brain structures involved in both domain-general and specific functions. The goal of this work was to assess the anatomical and cognitive affectations from a unique case with massive bilateral frontal affectation. We report the case of GC, an eight-year old child with nearly complete affectation of bilateral frontal structures and spared temporal, parietal, occipital, and cerebellar regions. We performed behavioral, neuropsychological, and imaging (MRI, DTI, fMRI) evaluations. Neurological and neuropsychological examinations revealed a mixed pattern of affected (executive control/abstraction capacity) and considerably preserved (consciousness, language, memory, spatial orientation, and socio-emotional) functions. Both structural (DTI) and functional (fMRI) connectivity evidenced abnormal anterior connections of the amygdala and parietal networks. In addition, brain structural connectivity analysis revealed almost complete loss of frontal connections, with atypical temporo-posterior pathways. Similarly, functional connectivity showed an aberrant frontoparietal network and relative preservation of the posterior part of the default mode network and the visual network. We discuss this multilevel pattern of behavioral, structural, and functional connectivity results. With its unique pattern of compromised and preserved structures and functions, this exceptional case offers new constraints and challenges for neurocognitive theories.
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Affiliation(s)
- Agustín Ibáñez
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia.
| | - Máximo Zimerman
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Lucas Sedeño
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Nicolas Lori
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; Laboratory of Neuroimaging and Neuroscience (LANEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Rosario, Argentina
| | - Melina Rapacioli
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Juan F Cardona
- Instituto de Psicología, Universidad del Valle, Cali, Colombia
| | | | - Eduar Herrera
- Departamento de Estudios Psicológicos, Universidad ICESI, Cali, Colombia
| | - Adolfo M García
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | - Facundo Manes
- Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
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