Arachnoid Cysts: State-of-the-Art

Foreword
Contents
Part I: General Information About Arachnoid Cysts
Editor’s Summary
History and Etymology of Arachnoid Cysts
1 Introduction
2 Early History
3 Serous Cysts in the Arachnoid
4 Organization of Lymph
5 Extravasation of Blood into the Cavity of the Arachnoid
6 Chronic and Asymptomatic
7 Early Surgical Experience
8 Spinal Arachnoid Cysts
9 Posterior Fossa Cysts
10 Primary Arachnoid Cysts
11 Temporal Lobe Agenesis
12 Arachnoid Cysts in the Age of Modern Imaging
13 Modern Presentation, Management, and Pathogenesis
14 Conclusion
References
Gender Distribution and Lateralization of Arachnoid Cysts
1 Introduction
2 Lateralization and Frequency
3 Gender Distribution
4 Gender Distribution and Lateralization According to Location
4.1 Supratentorial ACs
4.2 Infratentorial ACs
4.3 Spinal ACs
5 Conclusion
References
Embryology of Arachnoid Mater
1 Introduction
2 Histology and Location of Meninges Brain Tissue
3 Development of the Nervous System
4 Emergence of the Meninges
References
Histological Findings of Arachnoid Cysts
1 Introduction
2 Microscopic and Immunohistochemical Features of Arachnoid Cysts
2.1 Spectrum of Findings by Light Microscopy
2.2 Common Patterns of Immunohistochemical Labeling
3 Ultrastructural Features of Arachnoid Cysts
4 Pathologic Differentiation of Arachnoid Cyst from Other Cystic CNS Lesions
4.1 CNS Infections Presenting as Cysts
4.2 Neuroenteric (Enterogenous/Endodermal) Cysts
4.3 Colloid Cyst
4.4 Rathke’s Cleft Cyst
4.5 Epidermoid and Dermoid Cysts
4.6 Choroid and Ependymal Cysts
4.7 CNS Neoplasms with Cystic Components
4.8 Miscellaneous Cystic CNS Lesions
4.9 Unusual Clinicoradiographic Presentations of Arachnoid Cysts for which Histological Confirmation Is Prudent
5 Conclusion
References
Pathophysiology of Arachnoid Cysts
1 Introduction
2 Clinical and Radiographical Features
3 Pathophysiological Mechanisms
3.1 Ball Valve Mechanism
3.2 Secretory Effect of Arachnoid Lining and Presence of Choroid Plexus in some Cysts
3.3 The Osmotic Gradient Between Intracystic and Extracystic Spaces
4 Conclusion
References
Arachnoid Cysts: Biochemistry
1 Introduction
2 Pathophysiology
3 Biochemistry
3.1 Arachnoid Cyst Fluid Composition
3.2 Arachnoid Cyst Lining
4 Conclusion
References
Part II: Epidemiology of Arachnoid Cysts
Editor’s Summary
Incidence of Arachnoid Cysts
1 Introduction
2 Incidence of Arachnoid Cysts
3 Conclusion
References
Genetics of Arachnoid Cysts
1 Introduction
2 Method
3 Pathophysiology of ACs
4 Syndromes Associated with ACs
4.1 Glutaric Aciduria Type 1 (GA-1)
4.2 Aicardi Syndrome
4.3 Sturge-Weber Syndrome
4.4 Trigeminal Neuralgia
5 Other Syndromes Associated with ACs
6 Genetics of ACs
7 Hydrocephalus
8 Conclusion
References
Natural History of Arachnoid Cysts
1 Introduction
2 Natural History
3 Growth and Resolution
4 Management
5 Conclusion
References
Anatomic Locations of Arachnoid Cysts
1 Introduction
2 Intracranial Locations of Arachnoid Cysts
3 Intraspinal Locations of Arachnoid Cysts
4 Conclusion
References
Classification of Arachnoid Cysts
1 Introduction
2 Classification of Middle Fossa Temporal Cysts
2.1 Galassi Classification
3 Suprasellar Arachnoid Cyst Classification
4 Retroclival Arachnoid Cyst Classification
5 Spinal Arachnoid Cysts
6 Conclusion
References
Intracranial Hemorrhage Associated with Arachnoid Cysts
1 Introduction
2 Etiology and Classification
3 Risk Factors
4 Diagnosis and Presentation
5 Treatment
6 Outcome
7 Case Presentation
8 Conclusion
References
Spontaneous Resolution of Arachnoid Cysts
1 Introduction
2 Historical Background
3 Impact of the Disease
4 Radiological Evaluation of Arachnoid Cysts
5 Clinical Manifestations of ACs
6 Management of AC
7 Pathophysiology of Spontaneous Resolution of AC
8 Preferential Resolution of AC According to Its Site
9 Proposed Mechanism for the Spontaneous Resolution of ACs
10 Spontaneous Resolution of a Prepontine AC
11 Spontaneous Resolution of a Middle Cranial Fossa AC
11.1 Surgical Nuances
12 Spontaneous Resolution of an Interhemispheric AC
13 Spontaneous Resolution of a Suprasellar AC
14 Spontaneous Resolution of a Quadrigeminal AC
15 Spontaneous Resolution of Cerebellar AC
16 Spontaneous Resolution of a Spinal AC
17 Lesions Mimicking an AC, with Varied Presentation
18 Conclusion
References
Part III: Neuroimaging of Arachnoid Cysts
Editor’s Summary
Radiological Evaluation of Arachnoid Cysts
1 Introduction
2 Pathology, Etiology, and Clinical Symptoms
3 Radiological Diagnosis of Arachnoid Cysts
3.1 Antenatal Ultrasonography
3.2 Computed Tomography
3.3 Magnetic Resonance Imaging
3.4 Cisternography
3.5 Fetal Magnetic Resonance Imaging
4 Symptoms and Management of ACs
5 Intracranial Location of Arachnoid Cysts
5.1 Sylvian Fissure/Middle Cranial Fossa
5.2 Sellar Region
5.3 Interhemispheric Region
5.4 Convexity
5.5 Quadrigeminal Plate
5.6 Intraventricular Region
5.7 Infratentorial Region
6 Differential Diagnosis
7 Conclusion
References
Intrauterine Detection of Arachnoid Cysts
1 Introduction
2 Case Presentation of Prenatal Detection of the Arachnoid Cyst
3 Discussion
3.1 Prenatal Diagnosis
3.2 Natural Course
3.3 Size Change
3.4 Pregnancy Situation After Prenatal Diagnosis
3.5 Associated Anatomical Abnormalities
3.6 Neurodevelopment
3.7 Fetal Outcome
4 Conclusion
References
Cisternography of Arachnoid Cysts
1 Introduction
1.1 Isotope Cisternography
1.2 CT Cisternography (CTC)
1.3 MR Cisternography (MRC)
1.3.1 Non-contrast Material-Enhanced MR Cisternography (NCE-MRC)
1.3.2 Contrast Material-Enhanced MR Cisternography (CE-MRC)
1.4 Safety of Intrathecal Administration of Gadolinium-Based Contrast Agents
2 Conclusion
References
SPECT Imaging of Arachnoid Cysts
1 Introduction
2 Diagnosis of ACs
3 SPECT Imaging
4 Advantages of SPECT Imaging
5 SPECT Imaging for the Detection of ACs
6 Challenges That Need to Be Addressed for SPECT Imaging
7 Conclusion
References
Part IV: Clinical Presentations and Differential Diagnosis of Arachnoid Cysts
Editor’s Summary
Symptomatology of Craniospinal Arachnoid Cysts
1 Introduction
2 Intracranial Arachnoid Cysts
3 Spinal Arachnoid Cysts
4 Conclusion
References
Arachnoid Cysts Associated with Hydrocephalus
1 Introduction
2 Etiological and Pathogenetic Features
3 Clinical Signs-Symptoms and Location
4 Differential Diagnosis and Natural Evolution
5 Surgical Management
6 Conclusions
References
Epilepsy and Arachnoid Cysts
1 Introduction
2 Epidemiology
3 Pathophysiology
4 Electroclinical and Imaging Features
5 Diagnostic Workup
6 Management of the Association of Arachnoid Cyst with Epilepsy
7 Conclusion
References
Psychiatric Manifestations of Arachnoid Cysts
1 Introduction
2 Psychiatric Symptoms or Disorders Related to ACs
3 Cognition in ACs
4 Physiopathology
5 ACs in Patient Populations with Psychiatric Disorders
6 Psychiatric Treatments
7 Conclusion
References
Differential Diagnosis of Intracranial Arachnoid Cysts
1 Introduction
2 Subdural Hygromas
3 Chronic Subdural Hematomas
4 Epidermoid and Dermoid Cysts
5 Cystic Tumors
5.1 Pilocytic Astrocytomas
5.2 Hemangioblastomas
5.3 Gangliogliomas
5.4 Tumors Developed in the Subarachnoid Space
5.5 Low-Density Tumors
6 Non-neoplastic Cysts
6.1 Neurenteric Cysts
6.2 Ependymal Cysts
6.3 Neuroglial Cysts
7 Dandy-Walker Malformations
8 Schizencephaly
9 Neonatal Hypoxic-Ischemic Encephalopathy
10 Encephalomalacia
11 Infectious Lesions
11.1 Subdural Empyemas
11.2 Neurocysticercosis
11.3 Hydatid Cysts
12 Giant Intracranial Aneurysms
13 Intraventricular Cysts
13.1 Colloid Cysts
13.2 Choroid Fissure Cysts
13.3 Choroid Plexus Cysts
13.4 Ventricular Diverticula
14 Pineal Cysts
15 Cystic Suprasellar Lesions
15.1 Dilated Third Ventricle
15.2 Rathke’s Cleft Cysts
15.3 Craniopharyngiomas
16 Common Anatomical Variants
16.1 Mega Cisterna Magna
16.2 Tumefactive Perivascular Spaces
16.3 Cavum Septum Pellucidum
17 Meningoceles and Pseudomeningoceles
18 Conclusion
References
Differential Diagnosis of Intraspinal Arachnoid Cysts
1 Introduction
2 Hydro-Syringomyelia
3 Spinal Hygromas
4 Spinal Subdural Hematomas
5 Cystic Tumors
6 Non-Neoplastic Cysts
6.1 Epidermoid and Dermoid Cysts
6.2 Neurenteric Cysts
6.3 Ependymal Cysts
6.4 Bronchogenic Cysts
7 Ventriculus Terminalis
8 Dural Ectasia
9 Infectious Lesions
9.1 Hydatid Cysts
9.2 Suppurations
9.3 Cysticercosis
10 Meningoceles and Pseudomeningoceles
11 Spinal Degenerative Cysts
12 Spinal Cord Herniation
13 Other Cyst-Like Entities
14 Conclusion
References
Part V: Options in Operative Management of Arachnoid Cysts
Editor’s Summary
Aspiration and Drainage of Arachnoid Cysts
1 Introduction
2 Treatment Options for Arachnoid Cysts
3 Cystoperitoneal (CP) Shunting as Primary Treatment
4 Needle Aspiration or Burr Hole Drainage for the Arachnoid Cysts
5 Conclusion
References
Microsurgical Approach to Arachnoid Cysts
1 Introduction
1.1 Incidence
1.2 Natural History
1.3 Location
2 Presentation
3 Indications for Surgical Intervention
4 Treatment Options
4.1 Conservative Management
4.2 Microsurgery
4.3 Neuroendoscopy
4.4 CSF Diversion
4.5 Choice of Treatment Modality
5 Conclusion
References
Shunt Placement for Arachnoid Cysts
1 Introduction
2 Diagnosis
3 Conservative Treatment
4 Surgical Treatment
5 Conclusion
References
Stereotactic Internal Diversion of Arachnoid Cysts
1 Introduction
2 Prevalence of Arachnoid Cysts
3 Treatments of Intracranial Arachnoid Cysts
4 Craniotomy Fenestration to Treat Arachnoid Cysts
5 Endoscopic Fenestration for the Treatment of Arachnoid Cysts
6 Shunt Placement for the Treatment of Arachnoid Cysts
7 Conclusion
References
Endoscopic Approach to Arachnoid Cysts
1 Introduction
2 Pathophysiology
3 History of Neuroendoscopy
4 Surgical Indications
5 Surgical Technique
6 Strengths and Limitations of Neuroendoscopy in Arachnoid Cyst
7 Conclusion
References
Surgical Management of Spinal Arachnoid Cysts
1 Introduction
2 Patient Selection and Preoperative Evaluation
3 Surgical Principles
4 Surgical Therapy for Extradural Arachnoid Cysts
5 Surgical Therapy for Intradural Extramedullary Arachnoid Cysts
6 Surgical Therapy for Intramedullary Arachnoid Cysts
7 Surgical Therapy for Tarlov Cysts
8 Minimally Invasive Techniques
9 Postoperative Complications
10 Conclusion
References
Postoperative Complications Associated with Arachnoid Cysts
1 Introduction
2 Treatment Methods for Arachnoid Cysts
3 Complications of Arachnoid Cyst Surgery
3.1 Anesthetic Consideration
3.2 Surgical Complications
4 Conclusion
References
Part VI: Outcome and Prognosis of Arachnoid Cysts
Editor’s Summary
Recurrence of Arachnoid Cysts
1 Introduction
2 Natural History of Arachnoid Cysts
3 Surgical Treatment of Arachnoid Cysts
4 Recurrence of Arachnoid Cysts Following Surgical Intervention
5 Conclusion
References
Follow-Up of Arachnoid Cysts: Brain Plasticity Following Surgery for Arachnoid Cysts
1 Introduction
2 Brain Compliance
3 How to Measure Cyst Volume
3.1 The MacDonald Method
3.2 Volumetric Segmentation
3.3 Method Comparison
3.4 Classification of Post-Operative Radiological Outcomes
4 Influence of Surgical Modality on Brain Plasticity
4.1 Endoscopic Series
4.1.1 Sylvian Fissure Cysts
4.1.2 Suprasellar Cysts
4.2 Open Series
4.3 Cysto-peritoneal Shunt Series
4.4 Series Comparing Surgical Modalities
5 Correlation of Symptomatology to Cyst Volume Reduction
6 Temporal Pattern of Cyst Volume Reduction
7 Brain Plasticity in Adults Compared to Children
8 Illustrative Cases
8.1 Case 1: Sylvian Fissure
8.2 Case 2: Convexity AC
8.3 Case 3: Suprasellar AC
9 Proposed Algorithm for the Follow-Up of Untreated Arachnoid Cysts
10 Conclusion
References
Future Management of Arachnoid Cysts
1 Introduction
2 State of the Art
3 Future of AC Treatment
3.1 Indications: Signaling the Path
3.2 Future Improvements in Endoscopic Surgery: Cysto-E(Cho)Volution
3.3 Robotic Surgery for AC Treatment: Are We Ready for the (Robo)Revolution?
4 Conclusion
References
Medicolegal Aspects of Arachnoid Cysts
1 Introduction
2 Myths and Facts Regarding the Management of an Arachnoid Cyst
2.1 Indications for Surgical Treatment
2.2 Relationship Between Clinical Symptoms and the Size of the AC
2.3 Relationship Between the Location of Headache and the Side of the AC
2.4 Resolution of Neurological Symptoms in the Early Postoperative Period
3 Case Scenarios of Malpractice due to the Negligent Management of the Arachnoid Cyst
3.1 Missed or Delayed Diagnosis and Treatment of an Arachnoid Cyst
3.2 Failure in the Diagnosis of Shunt Failure in a Child with Hydrocephalus Caused by an Arachnoid Cyst
3.3 Shunt Placement in an Asymptomatic Arachnoid Cyst
3.4 Failure in the Management of an Arachnoid Cyst by a Neurologist
3.5 Misdiagnosis of a Spinal Arachnoid Cyst as Motor Neurone Disease Causing Delayed Treatment
4 Comment Upon Case Scenarios
5 Conclusion
References
Index