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1.
No Shinkei Geka ; 47(5): 531-536, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31105076

RESUMO

Arachnoid cysts(AC)are benign cystic lesions often diagnosed in childhood. Although usually asymptomatic, AC can become symptomatic when the lesion size increases or coexists with a subdural hygroma or hematoma. AC patients with signs of increasing intracranial pressure(IICP)or neurological deficits may need surgical intervention; this usually results in a good prognosis. However, whether asymptomatic AC patients should undergo surgical treatment is controversial. Although trivial head trauma, such as that from contact sports, can cause subdural hematoma in AC patients, there are currently no definite criteria regarding sports participation for children with AC. CASE: A 12-year-old boy who belonged to a soccer club visited an ophthalmologist with the chief complaint of having had diplopia for two weeks. He was identified as having bilateral papilledema. Since he had been diagnosed with a right middle cranial fossa AC five years earlier, he was referred to our outpatient clinic. Cranial CT scans showed right chronic subdural hematoma alongside the AC. The patient subsequently underwent burr hole surgery and was discharged after one week. In this case, the patient did not present with the typical signs of IICP, such as headache or vomiting. This experience indicates that care must be taken when encountering patients with atypical symptoms, particularly children. In addition, it is important to carefully consider sports participation for children with AC.


Assuntos
Cistos Aracnóideos , Hematoma Subdural Crônico , Papiledema , Cistos Aracnóideos/classificação , Criança , Fossa Craniana Média , Hematoma Subdural Crônico/complicações , Humanos , Masculino , Papiledema/complicações , Trepanação
2.
World Neurosurg ; 121: e898-e907, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30315978

RESUMO

BACKGROUND: The retroclival region is among the rarest locations for an arachnoid cyst (AC), with only a few reported cases. No accepted classification system is available for these rare cysts. Such a classification system would solve the nomenclature problem and could result in easier and more systematic management. We reviewed and analyzed data from databases and reported studies of retroclival ACs (RACs) and have proposed a classification system. METHODS: A retrospective review of RACs was conducted in Marmara and Adiyaman University Hospitals, Turkey. Cysts in the prepontine and/or premedullary cisterns that spared the chiasmatic cistern were included. Additionally, the reported data were searched for relevant studies on cysts. The findings were analyzed to establish a clear nomenclature and classification system, and the clinical presentations, treatment strategies, and surgical approaches were reviewed. RESULTS: We identified 1 adult and 1 pediatric patient, and only the adult had undergone surgery. Additional data searches yielded 14 patients with RACs. The cysts were classified as type 1 if they had extended superiorly beyond the borders of the diencephalic leaf of the Liliequist membrane. If they had not extended, they were classified as type 2. Finally, type 2 cysts that had extended to the anterior spinal cistern were classified as type 3. CONCLUSIONS: RACs can be more easily and systematically managed using a simple clinical classification system. Together with the previously proposed suprasellar AC classification, our proposed RAC classification should be adequate to classify all ACs in the ventral midline cistern, which could solve the nomenclature problem.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Neurocirurgia/métodos , Adulto , Cistos Aracnóideos/diagnóstico por imagem , Criança , Bases de Dados Bibliográficas/estatística & dados numéricos , Feminino , Humanos , Imagem por Ressonância Magnética , Estudos Retrospectivos , Turquia
3.
Neurosurgery ; 78(3): 370-9; discussion 379-80, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26445374

RESUMO

BACKGROUND: Suprasellar arachnoid cysts (SAC) represent between 9% and 21% of pediatric arachnoid cysts. Recent improvements in magnetic resonance imaging, as well as increasing prenatal diagnosis, have allowed more precise knowledge and follow-up. OBJECTIVE: To describe a novel classification of SAC. METHODS: We present 35 cases of SAC treated between 1996 and 2014. Patient records and imaging studies were reviewed retrospectively to assess symptomatology, radiological findings, treatment, and long-term follow-up. RESULTS: Fourteen SAC were diagnosed prenatally (39%). We observed 15 (43%) cases presenting hydrocephalus (SAC-1) removing Liliequist membrane downward. Lower forms (SAC-2) with free third ventricle were observed in 11 (31%) cases. Asymmetrical forms (SAC-3) with Sylvian or temporal extension were seen in the 9 (26%) remaining patients. Twenty-three (66%) patients were treated by ventriculocisternostomy, 3 (8.5%) by shunt surgery, and 3 (8.5%) by craniotomy. Six (17%) patients had no surgery, including 5 cases (14%) that had prenatal diagnosis. Outcomes were initially favorable in 26 cases (87%). Eight (22%) patients had endocrine abnormalities at the end of the follow-up, 3 (8.5%) had developmental delay, and 6 (17%) had minor neuropsychological disturbances. CONCLUSION: SAC are heterogeneous entities. SAC-1 may come from an expansion of the diencephalic leaf of the Liliequist membrane. SAC-2 show a dilatation of the interpeduncular cistern and correspond to a defect of the mesencephalic leaf of the Liliequist membrane. SAC-3 correspond to the asymmetrical forms expanding to other subarachnoid spaces. Surgical treatment is not always necessary. The recognition of the different subtypes will allow choosing the best treatment option.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Procedimentos Neurocirúrgicos/métodos , Cistos Aracnóideos/mortalidade , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Prognóstico , Estudos Retrospectivos
4.
Cir Cir ; 84(6): 487-492, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26698384

RESUMO

BACKGROUND: Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression. CLINICAL CASE: The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis. There was decreased sensitivity and strength of the pelvic limbs and gradually presented with anaesthesia from T12 to L4 dermatomes, L5 and S1 bilateral hypoaesthesia and 4+/5 bilateral strength, in the L2 root and 2+/5 in L3, L4, L5, S1, hyperreflexia, Babinski and clonus, but with no alteration in the sacral reflexes. In the magnetic resonance it was diagnosed as an extradural arachnoid cyst from T6 to T9. The patient underwent a T6 to T10 laminotomy, cyst resection, dural defect suture, and laminoplasty. One year after surgery, the patient had recovered sensitivity, improvement of muscle strength up to 4+/5 in L2 to S1, and normal reflexes. CONCLUSIONS: After the anaesthetic procedure, increased pressure and volume changes within the cyst could cause compression of the spinal cord, leading to symptoms. Despite being a long-term compression, the patient showed noticeable improvement.


Assuntos
Anestesia Epidural/efeitos adversos , Cistos Aracnóideos/etiologia , Paraparesia Espástica/etiologia , Complicações Pós-Operatórias/etiologia , Adolescente , Fraturas do Tornozelo/cirurgia , Cistos Aracnóideos/classificação , Cistos Aracnóideos/diagnóstico por imagem , Cistos Aracnóideos/cirurgia , Pressão do Líquido Cefalorraquidiano , Espaço Epidural , Fixação Interna de Fraturas , Humanos , Laminectomia , Laminoplastia , Masculino , Recuperação de Função Fisiológica , Transtornos das Sensações/etiologia , Compressão da Medula Espinal/etiologia , Vértebras Torácicas
5.
Medicine (Baltimore) ; 94(44): e1749, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26554773

RESUMO

We performed a dynamic study of arachnoid cysts (ACs) using magnetic resonance cisternography (MRC) and proposed a classification of ACs.Twenty-three suitable patients in our hospital entered into this study according to our inclusion criteria. MRC images were collected in all the subjects at 1 and 24 hours after the administration of intrathecal gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA). We allocate the enrolled patients into 2 groups, MRC group and surgery group. The MRC results were considered before treatment in 1 group (MRC group, 13 patients), whereas another group was surgically treated without considering the MRC results (surgery group, 10 patients). We calculated the enhanced area of cyst using modified MacDonald Criteria from the images and measured the surrounding subarachnoid area as the reference.We found that it was practically useful to quantify 3 types of ACs, complete communicating, incomplete communicating, and noncommunicating, according to MRC results in this study. All the subjects in both groups are closely observed before the treatment and the follow-up using the MRI examination. In the surgery group, 5 patients were found that the area of cysts shrank in the follow-up stage. However, there was no significant difference in the percentage shrinkage area between the 2 groups.We concluded that MRC with Gd-DTPA as a contrast agent is of significant clinical value for the diagnosis and treatment of children with intracranial ACs. This classification based on dynamic MRC is useful for making surgical recommendations.


Assuntos
Cistos Aracnóideos/classificação , Imagem por Ressonância Magnética/métodos , Mielografia/métodos , Procedimentos Neurocirúrgicos/métodos , Punção Espinal/métodos , Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Resultado do Tratamento
6.
Neurocir.-Soc. Luso-Esp. Neurocir ; 26(5): 234-240, sept.-oct. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-142309

RESUMO

La prevalencia de los quistes aracnoideos en niños es del 1-3%. Son más frecuentes en el sexo masculino. Pueden localizarse tanto en el espacio intracraneal como a nivel espinal. Los intracraneales se clasifican en supratentoriales, infratentoriales y supra-infratentoriales. Los supratentoriales se subclasifican en de fosa media, hemisféricos de la convexidad, interhemisféricos, de la región selar e intraventriculares. Los infratentoriales se subdividen a su vez en supracerebelosos, infracerebelosos, hemisféricos, clivales y de ángulo pontocerebeloso. Por último, los espinales se clasifican según su localización extra o intradural y su afectación de raíces nerviosas (AU)


The prevalence of arachnoid cysts in children is 1-3%. They are more frequent in boys. They can be located intracranially or in the spine. Intracranial cysts are classified as supratentorial, infratentorial, and supra-infratentorial (tentorial notch). Supratentorial are divided into middle cranial fossa, convexity, inter-hemisferic, sellar region, and intraventricular. Infratentorial are classified into supracerebellar, infracerebellar, hemispheric, clivus, and cerebellopontine angle. Finally spinal arachnoid cysts are classified taking into account whether they are extra- or intradural, and nerve root involvement (AU)


Assuntos
Criança , Humanos , Cistos Aracnóideos/cirurgia , Procedimentos Neurocirúrgicos/métodos , Cistos Aracnóideos/classificação , Cistos do Sistema Nervoso Central/classificação , Espectroscopia de Ressonância Magnética
7.
Neurocirugia (Astur) ; 26(5): 234-40, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25843209

RESUMO

The prevalence of arachnoid cysts in children is 1-3%. They are more frequent in boys. They can be located intracranially or in the spine. Intracranial cysts are classified as supratentorial, infratentorial, and supra-infratentorial (tentorial notch). Supratentorial are divided into middle cranial fossa, convexity, inter-hemisferic, sellar region, and intraventricular. Infratentorial are classified into supracerebellar, infracerebellar, hemispheric, clivus, and cerebellopontine angle. Finally spinal arachnoid cysts are classified taking into account whether they are extra- or intradural, and nerve root involvement.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/epidemiologia , Encéfalo/patologia , Ângulo Cerebelopontino/patologia , Criança , Fossa Craniana Posterior/patologia , Humanos , Doenças da Medula Espinal/classificação , Doenças da Medula Espinal/epidemiologia
8.
World Neurosurg ; 79(2 Suppl): S19.e13-8, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22381821

RESUMO

BACKGROUND: The first case of an intracranial arachnoid cyst was described by Bright in 1831. In 1935, Barlow published the first case of a suprasellar arachnoid cyst. Fewer than 200 cases of suprasellar-prepontine arachnoid cysts have been reported in the literature as of January 2011. METHODS: Between 1994 and 2010, the senior author operated on 34 cases of suprasellar-prepontine arachnoid cysts. Eighteen female and 16 male patients ranged in age from 6 days to 16 years (mean 5.2 years). Follow-up of the patients ranged from 1 year to 16 years. RESULTS: Outcome may be evaluated according to radiological and clinical follow-up data. Postoperative radiological examinations must reveal: 1) the adequacy of fenestrations and flow through fenestration sites, 2) reduction of the cyst and ventricle size, and 3) reorientation of the chiasma and mammillary bodies to an acceptable anatomical position. In our series, no mortality occurred. Postoperative complication occurred in 3 cases. CONCLUSIONS: Suprasellar arachnoid cysts can be treated with favorable clinical and radiological results with endoscopic interventions when feasible. Results with ventriculocystocisternostomy are believed superior to those of ventriculocystostomy.


Assuntos
Cistos Aracnóideos/cirurgia , Cistos do Sistema Nervoso Central/cirurgia , Endoscopia/métodos , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Adolescente , Adulto , Cistos Aracnóideos/classificação , Cistos Aracnóideos/complicações , Cistos Aracnóideos/epidemiologia , Cistos Aracnóideos/patologia , Criança , Pré-Escolar , Feminino , Humanos , Hidrocefalia/etiologia , Lactente , Imagem por Ressonância Magnética , Masculino , Terminologia como Assunto , Resultado do Tratamento
9.
Clin Neurol Neurosurg ; 115(4): 411-8, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22790328

RESUMO

OBJECTIVE: The optimal management for middle fossa arachnoid cysts (MFAC) remains controversial, but cystocistern fenestration is effective. MFACs are divided into non-communicating arachnoid cysts (NCIAC) and communicating arachnoid cysts (CIAC). This retrospective observational study evaluated the role of phase-contrast cine magnetic resonance imaging (PC-MRI) in the diagnosis and postoperative evaluation of MFACs and assessed surgical outcomes. METHODS: Twenty-eight children with MFAC that were diagnosed by conventional neuroradiology were enrolled. PC-MRI was performed preoperatively. The clinical manifestations, cyst volumes and PC-MRI data were analyzed, and the flow of cerebrospinal fluid (CSF) at the fistula was qualitatively evaluated. RESULTS: No communication with the adjacent subarachnoid space was found on preoperative PC-MRI in 20 patients, and they were diagnosed with NCIAC. A statistically significant decrease in cyst volume was observed in all 20 patients postoperatively. Symptoms resolved or improved in the 14 patients who were symptomatic preoperatively, and a positive CSF flow was found in all 20 patients postoperatively. PC-MRI diagnosed eight patients with CIAC, and the cyst sizes did not increase during follow-up. CONCLUSIONS: Cystocistern fenestration is an effective treatment for children with lateral fissure IAC. PC-MRI can be used to determine the IAC type and to evaluate the effectiveness of cystocistern fenestration.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Fossa Craniana Média/patologia , Fossa Craniana Média/cirurgia , Adolescente , Algoritmos , Cistos Aracnóideos/patologia , Circulação Cerebrovascular , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Cefaleia/etiologia , Humanos , Processamento de Imagem Assistida por Computador , Lactente , Hipertensão Intracraniana/etiologia , Imagem por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Derrame Subdural/etiologia , Resultado do Tratamento , Vômito/etiologia
10.
Med. infant ; 19(3): 233-235, sept. 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-774329

RESUMO

El diagnóstico es Quiste aracnoideo de la fosa media con extensión a la fosa anterior Galassi III


Assuntos
Humanos , Masculino , Lactente , Fossa Craniana Anterior , Fossa Craniana Média , Cistos Aracnóideos/classificação , Cistos Aracnóideos/congênito , Argentina
11.
J Neurol Sci ; 318(1-2): 125-30, 2012 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-22520095

RESUMO

OBJECTIVES: The symptom and neuroimaging as indications for treating arachnoid cysts (ACs) are not adequate. Understanding the communication between cyst and subarachnoid space is helpful for decision-making. We took a dynamic study of ACs using CT cisternography (CTC) and proposed a classification of arachnoid cysts. MATERIALS AND METHODS: Total 52 symptomatic patients with ACs were enrolled in this prospective study. CTC images were ordered, in all enrolled patients, at the 1, 3, 6, 12, 24 and 48 h after the intrathecal Omnipaque administration. Enhancement in cysts was measured quantitatively and was compared with neighboring subarachnoid spaces. All enrolled patients were allocated randomly in 2 groups. The CTC result was considered before treatment in one group (CTC group), while another group was surgically treated without considering CTC results (surgical group). RESULTS: ACs in our study were classified into 3 types: complete (cyst filling time at 1 h), incomplete (filling time began at 3 h) and noncommunicating cysts (no or slight filling after 24 h). Twenty-two patients in CTC group with incomplete communicating, or noncommunicating cysts underwent surgeries. And other 6 patients with complete communicating cysts were closely observed. In CTC group, the symptom of all surgical patients was relieved, and 5 out of 6 observational patients showed clinical improvement or no deterioration during the follow-up. In surgical group, only 18 out of 24 patients showed clinical improvement after surgeries, and there were 6 patients showing no difference before and after surgeries in symptom and in imaging. CONCLUSIONS: This classification based on dynamic CT cisternography is useful for the decision of surgical indication. Some symptomatic patients with complete communicating ACs may not need surgical intervention.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Procedimentos Neurocirúrgicos/normas , Espaço Subaracnóideo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Cistos Aracnóideos/cirurgia , Encéfalo/patologia , Encéfalo/cirurgia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espaço Subaracnóideo/patologia , Espaço Subaracnóideo/cirurgia , Adulto Jovem
12.
Zhonghua Yi Xue Za Zhi ; 91(25): 1742-5, 2011 Jul 05.
Artigo em Chinês | MEDLINE | ID: mdl-22093730

RESUMO

OBJECTIVE: To evaluate the method, strategy and efficacy of treating different types of quadrigeminal cistern arachnoid cysts (QCAC) with neuroendoscope. METHODS: A retrospective analysis was conducted for 12 QCAC patients with obstructive hydrocephalus. They were classified into 3 types and underwent neuroendoscopic operation at our hospital between November 2005 and November 2009. Their surgical approaches, complications and efficacy were analyzed. The mean age of first diagnosis was 3.7 years old. There were 7 type II cases and 5 type III cases with a varying level of symptoms. The follow-up period was 6 - 24 months. Cine-MRI (magnetic resonance imaging) examination was performed both preoperatively and post-operatively. RESULTS: Among them, 12 patients recovered well without any occurrence of hemorrhage, paralysis, lower cranial nerve injury, cerebrospinal fluid leakage, infection or death. Subdural effusion occurred in 3 cases, but disappeared within 6 months. Seven feverish cases recovered after a symptomatic treatment. The shapes of cysts and ventricles almost returned to a normal level in 8 cases. Three cases of arachnoid cyst had a slight change. CONCLUSION: In accordance with the QCAC patient types, different neuroendoscopic approaches can fully reconstruct the cerebrospinal fluid circulation. And the use of frameless navigation makes it more precise and safe.


Assuntos
Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Neuroendoscopia/métodos , Adolescente , Criança , Pré-Escolar , Craniotomia/métodos , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Teto do Mesencéfalo
13.
Zhonghua Yi Xue Za Zhi ; 90(41): 2932-4, 2010 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-21211400

RESUMO

OBJECTIVE: To make a clear distinction of intrasellar cystic lesions: craniopharyngioma (CR), Rathke's cleft cyst (RCC), cystic pituitary adenoma (PA) and intrasellar arachnoid cyst (AC). METHODS: A total of 72 adult patients underwent transsphenoidal approach for the removal of intrasellar cystic lesions. The authors conducted a study to (1) investigate preoperative clinical, biochemical and radiographic features of patients with CR, RCC, PA and AC; (2) identify clinicopathological features of independently predicting recurrence in CR, PA and RCC in adults. These adult patients included CR (n = 10), RCC (n = 27), cystic PA (n = 32) and 1 patient with AC (n = 1). RESULTS: The CR patients presented with hypopituitarism in 80% of cases. According to the biochemical criteria, the percentage of patients with a slight prolactin increase happened in PA (55.6%) and RCC (44.4%). Cystic PA had post-contrasting enhancement in cyst wall because of tumor tissue. Calcification detectable on computed tomographic scanning was present in 70% of CR patients. It was a significantly greater proportion compared to other diseases. Typical RCC was located between anterior and posterior pituitary and the contents in RCC were variable. Mass effects vanished post-operatively in all kinds of lesions. Long-term hormone replacement therapy was administered more in CR patients (60%) and diabetes insipidus than other lesions. One PA patient and 2 CR patients had recurrence during a follow-up of 12 - 52 months (mean: 34). RCC and AC had no recurrence. CONCLUSION: Craniopharyngioma, Rathke's cleft cyst, cystic pituitary adenoma and intrasellar arachnoid cyst are a spectrum of diseases with different therapeutic strategies. An accurate diagnosis of these lesions is essential so as to determine the type of treatment to improve outcome.


Assuntos
Cistos Aracnóideos/cirurgia , Craniofaringioma/cirurgia , Neoplasias Hipofisárias/cirurgia , Adolescente , Adulto , Idoso , Cistos Aracnóideos/classificação , Cistos do Sistema Nervoso Central/classificação , Cistos do Sistema Nervoso Central/cirurgia , Craniofaringioma/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Surg Neurol ; 68(2): 149-54; discussion 154, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17662345

RESUMO

BACKGROUND: The aim of this study was to explore the CTC classification, establish surgical indication, and evaluate neuroendoscopic treatment of IAC. METHODS: Computed tomographic cisternography was applied to screen NCIAC cases out of 22 patients with IAC. Noncommunicating intracranial arachnoid cyst cases were treated with neuroendoscopic fenestration between IAC and cerebral cistern/ventricle with rigid neuroendoscope. RESULTS: All the NCIAC patients had definite neurologic findings. Postoperatively, the clinical status and situations of all the patients were improved, and some patients were even cured. Only 1 case suffered complicated chronic subdural hematoma and was cured by burr hole drainage. Follow-up CT scan of 9 cases showed that the cysts decreased markedly in size; most of the surrounding spaces were filled by normal cerebral tissue. CONCLUSION: (1) CTC is specific for the differential diagnosis of IAC, which can be classified into CIAC and NCIAC with CTC. (2) NCIAC with definite neurologic findings have surgical indication. (3) Compared with traditional treatments, neuroendoscopic cystic fenestration is more effective and minimally invasive with less mortality and morbidity.


Assuntos
Cistos Aracnóideos/diagnóstico , Cistos Aracnóideos/cirurgia , Neuroendoscopia , Adolescente , Adulto , Cistos Aracnóideos/classificação , Criança , Cisterna Magna/diagnóstico por imagem , Cisterna Magna/patologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Tomografia Computadorizada por Raios X , Resultado do Tratamento
15.
Radiat Med ; 24(6): 471-81, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16958432

RESUMO

This article describes a classification and imaging diagnosis of intracranial midline cystic malformations based on neuroembryologic analysis. Midline cystic malformations are classified into two categories from an embryologic point of view. In one category, the cyst represents expansion of the roof plate of the brain vesicle, and in the other the cyst consists of extraaxial structures such as an arachnoid membrane or migrating ependymal cells. Infratentorial cysts, such as the Dandy-Walker cyst or Blake's pouch cyst, and supratentorial cysts, such as a communicating interhemispheric cyst with callosal agenesis or a dorsal cyst with holoprosencephaly, are included in the first category. Infratentorial arachnoid cavities, such as the arachnoid cyst, arachnoid pouch, and mega cisterna magna, are in the second category. Noncommunicating interhemispheric cysts, such as interhemispheric arachnoid cyst or ependymal cyst, with callosal agenesis are also in the second category. A careful review of embryologic development is essential for understanding these midline cysts and for making a more accurate radiologic diagnosis.


Assuntos
Encéfalo/anormalidades , Cistos do Sistema Nervoso Central/classificação , Cistos do Sistema Nervoso Central/embriologia , Síndrome de Dandy-Walker/embriologia , Síndrome de Dandy-Walker/patologia , Cistos Aracnóideos/classificação , Cistos Aracnóideos/embriologia , Encéfalo/embriologia , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cistos do Sistema Nervoso Central/patologia , Síndrome de Dandy-Walker/diagnóstico por imagem , Humanos , Radiografia
17.
J Comput Assist Tomogr ; 26(4): 647-53, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12218836

RESUMO

The authors present CT and MRI of a patient with an extremely large arachnoidal cyst (Galassi classification type III). The cyst extended from the base of the skull, posterior to the brain stem, on the base of the temporal lobe over the complete convexity of the left hemisphere. The cyst consisted of multiple compartments with intracystic septa and was accompanied by a chronic subdural hemorrhage in the compartments. After contrast agent application, the typical characteristics of chronic subdural membranes were found. Besides bony deformities, a thinning of the inner table was found. The patient underwent craniotomy for evacuation of the hemorrhage and fenestration of the septa while he was free of symptoms. This is a remarkable case proving that chronic local intracranial pressure does not inevitably lead to neurologic symptoms or intellectual disabilities.


Assuntos
Cistos Aracnóideos/diagnóstico , Hematoma Subdural Crônico/diagnóstico , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Adulto , Cistos Aracnóideos/classificação , Cistos Aracnóideos/cirurgia , Craniotomia , Seguimentos , Hematoma Subdural Crônico/classificação , Hematoma Subdural Crônico/cirurgia , Humanos , Pressão Intracraniana/fisiologia , Masculino , Exame Neurológico
19.
Acta méd. (Porto Alegre) ; (1): 201-12, 1995. tab, ilus
Artigo em Português | LILACS | ID: lil-198409

RESUMO

O cisto aracnóideo é um importante processo expansivo que atinge o sistema nervoso. Os autores reuniram, nesta revisäo, aspectos relevantes para a compreensäo e o manejo desta patologia


Assuntos
Humanos , Cistos Aracnóideos/fisiopatologia , Cistos Aracnóideos/classificação , Cistos Aracnóideos/história , Cistos Aracnóideos/terapia
20.
Rev Med Interne ; 11(4): 280-4, 1990.
Artigo em Francês | MEDLINE | ID: mdl-2096431

RESUMO

In a 63-year old male patient coccygodynia, initially isolated then complicated by incomplete cauda equina syndrome, could be attributed to large perineurel meningeal cysts on the sacral nerve roots. The diagnosis was suspected at computerized tomography and nuclear magnetic resonance and confirmed by sacculoradiculography. Intradural injections of corticosteroids provided lasting pain relief. Arachnoid cysts are often asymptomatic, by they may be responsible for coccygodynia and/or incomplete cauda equina syndrome. Their presence is suggested by the characteristics of the symptoms which are paroxysmal, exacerbated in standing position, relieved in dorsal position and revived by percussing the sacrum. Treatment is medical in most cases. The decision to operate depends on the persistence and intensity of pain and on whether signs of neurological defecit are present.


Assuntos
Cistos Aracnóideos/complicações , Cóccix , Dor/etiologia , Cistos Aracnóideos/classificação , Cistos Aracnóideos/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade
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