Arachnoid cyst

Case contributed by Varun Babu , 17 Jul 2016
Diagnosis almost certain
Changed by Mostafa Elfeky , 18 Jul 2023
Disclosures - updated 14 May 2023: Nothing to disclose

Updates to Study Attributes

Findings was changed:
  • no intra axial-axial or extra axial hemorrhage.-axial haemorrhage

  • no calvarial fracture.

  • large extra axial-axial CSF attenuating lesion is seen occupying the left middle cranial fossa splaying the sylvianSylvian fissure and displacing the frontal, parietal and temporal lobes

  • secondary mass effect is seen in the form of effacement of left cerebral hemispheric sulci, mild midline shift to right,  effacedeffaced ipsilateral lateral ventricle

  • no transtentorial herniation.  

Images Changes:

Image CT (non-contrast) ( update )

Cropped image

Image CT (non-contrast) ( update )

Cropped image

Image CT (non-contrast) ( update )

Cropped image

Updates to Study Attributes

Findings was changed:

Contrast enhanced-enhanced MRI confirms

  • non enhancing-enhancing nature of the lesion.

  • CSF attenuation

  • extra axial-axial location

    • displaced cortical mantle and cortical vessels between the lesion and calvarium

  • no underlying white matter changes in the left cerebral hemisphere

Images Changes:

Image MRI (DWI) ( update )

Cropped image

Updates to Case Attributes

Body was changed:

Most common site of origin of the arachnoid cyst is in the middle cranial fossa, splaying the Sylvian fissure. Depending on the size and extent, it is classified by the Galassi classification. This is a type III variant. 

They tend to be asymptomatic and pounced upon incidentally. The larger ones may cause symptoms secondary to mass effect. 

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