Presentation
Antenatally diagnosed suprasellar arachnoid cyst regression of speech over last ~3/12 - lost all words bar occasional use of "dada" will need sedation, please
Patient Data
3.3 cm cystic lesion in the sella cistern, following CSF on all sequences. No diffusion restriction. No solid component.
This splays hand displaces the optic chiasm anterosuperiorly, largely on the left side of the chiasm. The superior aspect of the cyst abuts the floor of third ventricle. No hydrocephalus.
The pituitary lies inferiorly within the sella. Smooth bony scalloping of the planum sphenoidale.
Normal appearances of the cerebral hemispheres and posterior fossa. Normal corpus callosum and midbrain.
Comment: Appearances in keeping with a suprasellar arachnoid cyst - significant mass effect on the optic pathway.
Case Discussion
The suprasellar location is one of the few sites where arachnoid cysts can just in symptoms and thus the potential need for surgery.
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