The human brain is a complex mechanism of the body, which is not fully understood and studied. For many centuries, scientists have been trying to solve all its secrets. Sometimes this mechanism may fail, as it develops benign or malignant neoplasms. One of the benign brain tumors is an arachnoid cyst. It is a thin-walled neoplasm that is filled with cerebrospinal fluid. The cyst membrane consists of the arachnoid (arachnoid) membrane of the brain. This pathology is most often diagnosed by chance during examination for another disease.
Problem Description
Arachnoid cyst is a neoplasm of a benign nature, which is localized between the surface of the brain and the arachnoid meninges, it is filled with cerebrospinal fluid (cerebrospinal fluid). At the location of the neoplasm, the arachnoid membrane of the brain is thickened, it is divided into two sheets, between which cerebrospinal fluid accumulates. Usually a cyst is small, but as it grows, it can put pressure on the cerebral cortex, which provokes the manifestation of negative symptoms of the disease.
Arachnoid cerebrospinal fluid cyst can have different localization. Most often, the tumor is located in the area of the cerebellopontine angle, temporal areas or above the Turkish saddle. According to medical data, pathology is observed in 4% of the world's population, most often among the stronger sex. Usually the neoplasm does not show signs of development, it does not threaten the life and health of the patient. It is necessary to distinguish between benign neoplasms such as retrocerebellar and arachnoid cysts of the brain. In the first case, a tumor forms inside the brain, while the second develops on its surface.
In medicine, a congenital and acquired form of pathology is isolated. In the first case, the neoplasm begins to form in the prenatal period. Acquired pathology develops as a result of infectious diseases of the brain, head injury, surgical procedures, and so on.
Like retrocerebellar, an arachnoid cyst is a benign mass that does not always require surgery. This neoplasm does not give metastases and does not transform into a cancerous tumor.
Varieties of pathology
According to morphological characteristics, it is customary to distinguish simple cysts consisting of arachnoid cells (they are endowed with the ability to produce cerebrospinal fluid), and complex cysts, which also include other structures. In practical neurology, this kind of neoplasm is not taken into account, physicians take into account only the etiological classification of pathology.
According to the clinical course, the arachnoid cyst of the brain can be progressive, which is characterized by an increase in symptoms due to an increase in its size, and frozen, which does not grow and has a hidden course. In medicine, an important point is the determination of the type of cyst according to this classification, since pathology therapy depends on it.
By location, tumors are isolated in the parietal zone of the head and an arachnoid cyst of the temporal region. Also, such cysts can develop in the lumbar spine and in the spinal canal.
Causes of the disease
The primary, or congenital, cyst occurs as a result of a disorder in the formation of the subarachnoid space or arachnoid membrane as a result of improper intrauterine development at the initial stage of pregnancy of a woman. The arachnoid membrane is then filled with a clear fluid having the same composition as the cerebrospinal fluid. The negative factors that contribute to the emergence of this pathology include the impact on the fetus of intrauterine infections, intoxication of the pregnant woman's body, the presence of bad habits, radiation exposure, overheating.
A secondary, or acquired, arachnoid cyst of the brain develops as a result of complications after previous inflammation of the brain, brain injury, hemorrhage in the subarachnoid space, surgery on the brain, as well as Marfan’s disease and agenesis, impaired cerebral circulation. If any disease affects the development of the cyst, then it will consist of scar tissue.
Cyst growth
Neoplasms in the brain can grow for the following reasons:
- Increased cerebrospinal fluid pressure inside the cyst.
- Inflammation of the meninges as a result of exposure to infections or arachnoiditis.
- A concussion in a person whose cyst has formed earlier.
If the size of the neoplasm increases, this means that provoking factors that need to be eliminated continue to act on the brain.
Symptoms and signs of pathology
Arachnoid cyst sizes can have different, therefore, the symptoms of the disease can manifest itself in different ways. Usually, the disease is detected during an examination related to other health problems. Sometimes the neoplasm exhibits unpleasant and dangerous symptoms, so in this case it requires therapy. This usually occurs with vascular, infectious or traumatic brain damage.
Since the arachnoid cyst of the left or right temporal lobe is most often found, it can provoke the appearance of nausea, causeless vomiting, dizziness. In a severe case, the development of ataxia and paresis, mental disorders, seizures, hallucinations is possible.
If the neoplasm has formed near the brain stem, it provokes the appearance of intervertebral hernias, a violation of the activity of some organs. In some cases, the disease causes secondary hydrocephalus, while the danger of this pathology lies in the possible rupture of the cyst.
With the accumulation of a large amount of cerebrospinal fluid inside the neoplasm, it begins to grow, intracranial pressure, neuralgia appears, the nature of the course of which will depend on the location of the cyst. With the growth of the neoplasm, new signs of pathology may appear. Often, a person has pressure on the eyeballs, impaired hearing and vision, the appearance of flies in front of the eyes, numbness of the limbs, dysarthria. In some cases, the arachnoid cyst, the lesion areas of which are extensive, leads to loss of consciousness and the development of a convulsive syndrome. A vivid manifestation of neuralgic symptoms indicates an active growth of the neoplasm, which compresses the brain. When the cyst ruptures, a fatal outcome occurs. In the absence of treatment, irreversible degenerative processes develop in the tissues of the brain. But the vivid symptomatology of the pathology is observed only in 20% of cases.
Diagnostic measures
Since in most cases the arachnoid cyst does not show signs, the diagnosis is made using laboratory and instrumental diagnostic methods. The exact location and size of the neoplasm helps establish MRI and CT. Next, the doctor needs to find out the causes of the disease. To do this, he assigns:
- Laboratory blood tests for its coagulability and cholesterol.
- Dopplerometry of the vessels of the neck and head.
- Studies of the cardiac and vascular systems.
- BP monitoring.
- Electroencephalography.
- Rheoencephalography.
- Tests for the presence of neuroinfections and autoimmune diseases.
Differential diagnosis
The doctor differentiates the pathology with diseases such as subdural hygroma, epidermoid cyst, chronic subdural bleeding, hemangioblastoma, astrocytoma, abscess, encephalitis, stroke, as well as non-tumor cysts and neurocysticercosis, metastatic brain tumors.
After a comprehensive examination, the doctor evaluates all the results, identifies possible causes of the disease and develops a treatment regimen.
Disease therapy
If the arachnoid cyst is small and does not show any signs, therapy is not performed. In this case, the patient is monitored, an annual MRI scan.
When the cyst is large, it exhibits symptoms, provokes the development of convulsions and hemorrhages, then the doctor suggests surgical intervention. Operations are prescribed in case of rapid growth of the cyst, increased intracranial pressure, high risk of rupture of the neoplasm, the manifestation of negative signs of pathology that interfere with the patient's life.
In modern medicine, an endoscopic method is often used for this purpose, in which a neoplasm is punctured and cerebrospinal fluid is pumped out of it. If there are contraindications to this operation, it is possible to use bypass surgery or microneurosurgical surgery, during which the arachnoid cyst of the brain is removed.
Medicines
After that, the doctor prescribes antioxidants, which contribute to the development of resistance of brain cells to intracranial pressure, nootropic drugs to saturate the brain cells with oxygen.
To normalize intracranial pressure, doctors usually prescribe therapy in several courses per year with Diakarb. Medicinal plants can also be prescribed that help reduce pressure, for example, omentum, violet, black elderberry or horsetail.
Forecast
Arachnoid cyst with proper and timely treatment has favorable prognoses. With a secondary neoplasm in the absence of treatment, a significant deterioration of the patient's condition occurs, he may develop complications that will be associated with a disorder of mental functions, the appearance of hydrocephalus, and even death. Sometimes new cysts may form, the growth of which will cause cerebral hemorrhage. Regular examinations with MRI allow doctors to monitor the manifestation of the disease and make assumptions about the possible development of complications, which helps to avoid unnecessary surgical interventions.
Prevention
Since a congenital pathology begins to form in the prenatal period, the prevention method in this case is taking care of a healthy pregnancy, eliminating addictions and exposure to toxins, radiation and carcinogens. The main preventive method in this case is the prevention of fetal hypoxia.
Secondary pathology is preventable, since the cause of its appearance is the primary disease. To prevent the formation of neoplasms in the brain, it is necessary to monitor blood pressure, blood cholesterol, treat infectious and autoimmune diseases in a timely manner, follow the recommendations and prescriptions of doctors after concussion, and surgical procedures.
Summary
Arachnoid cysts can occur in different ways. Most often, it does not show symptoms and signs, therefore, does not require special treatment. The main danger is a progressive neoplasm, with late diagnosis it can cause a person's disability due to neurological deficit and even lead to death. As a complication after surgery to remove the cyst, relapse may occur.
When diagnosing this disease, it is important to regularly undergo an examination with MRI in order to monitor the growth of the cyst. This will make it possible to timely respond to the progression of the pathology and eliminate it.