Presentation
Increased head circumference with visual disturbances.
Patient Data
The MRI sequences demonstrate a large extra-axial cyst in the left middle cranial fossa measuring (12 x 9.5 x 6 cm) of CSF signal on all sequences, extending to the fronto-insular region, compressing the temporal, frontal, and parietal lobes. A mass effect is noted on the midline structures with a midline shift.
Bilateral flattening of the posterior sclera with prominent subarachnoid space around the optic nerves which may indicate a secondary intracranial hypertension.
A small similar cyst is also noted in the anterior portion of the right middle cranial fossa measuring (3 x 2 x 1.5 cm),
Case Discussion
MRI features of a large compressive arachnoid cyst of the left middle cranial fossa, type III according to Galassi classification of middle cranial fossa arachnoid cysts. A small associated arachnoid cyst in the right middle cranial fossa (type I) is also noted.
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