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How To Get Rid Of Arachnoid Cyst?
Question: How do you remove an arachnoid cyst? How long of a recovery is it?
Brief Answer:
Several techniques.
Detailed Answer:
I read your question carefully and I understand you must be worried about your son.
There are several techniques possible:
-open surgery, called open cyst fenestration, which permits to inspect better the cyst, the blood vessels in the subarachnoid space and excision of the cyst wall. It produces quick resolve of the headaches but there is possibility of cyst reaccumulation in 5-25% of patients.
-endoscopic fenestration, opening a burr hole and entering with an andoscopic tube, perhaps the most popular technique right now, similar advantages and disadvantages to the open surgery.
-needle aspiration, is perhaps the simplest and quickest way but has a high rate of recurrence.
-shunting, meaning leaving inserted a draining catheter which connects the cyst to the abdomen draining the fluid in the abdomen. Is perhaps the most definitive treatment but it means remaining dependent on the shunt and the risk of complications like shunt infection.
The most preferred methods generally nowadays is the endoscopic one (the second), with other methods being used for particular cases like open fenestration for multiloculated cysts, or shunting as a last resort for recurrences or hydrocephalus (fluid build-up in the ventricles in the brain).
I would gladly review your sons MRI images if you can upload them.
Also remember that before rushing towards treatment it must be made sure that the cyst is the cause of the symptoms, most cysts do not need surgery. If the neurologists and neurosurgeon that the cyst size and location justifies the symptoms other causes must be considered and their treatment attempted.
I remain at your disposal for further questions.
Several techniques.
Detailed Answer:
I read your question carefully and I understand you must be worried about your son.
There are several techniques possible:
-open surgery, called open cyst fenestration, which permits to inspect better the cyst, the blood vessels in the subarachnoid space and excision of the cyst wall. It produces quick resolve of the headaches but there is possibility of cyst reaccumulation in 5-25% of patients.
-endoscopic fenestration, opening a burr hole and entering with an andoscopic tube, perhaps the most popular technique right now, similar advantages and disadvantages to the open surgery.
-needle aspiration, is perhaps the simplest and quickest way but has a high rate of recurrence.
-shunting, meaning leaving inserted a draining catheter which connects the cyst to the abdomen draining the fluid in the abdomen. Is perhaps the most definitive treatment but it means remaining dependent on the shunt and the risk of complications like shunt infection.
The most preferred methods generally nowadays is the endoscopic one (the second), with other methods being used for particular cases like open fenestration for multiloculated cysts, or shunting as a last resort for recurrences or hydrocephalus (fluid build-up in the ventricles in the brain).
I would gladly review your sons MRI images if you can upload them.
Also remember that before rushing towards treatment it must be made sure that the cyst is the cause of the symptoms, most cysts do not need surgery. If the neurologists and neurosurgeon that the cyst size and location justifies the symptoms other causes must be considered and their treatment attempted.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I wasn't able to get the file uploaded from dropbox. Please login with my username and password. They are in a file named XXXXXXX mri.
He has horrible pain on a daily basis. I have seen two neurologists in my area and neither were very helpful. One only wanted to medicate him for his "tic". Since he has been having pain he has very frequent eye rolling and head bobbing/rolling. His eyes will also shoot to the left as well as his head will shoot to the left. I am not interested in medicating him for that at this time. How can i be sure these things aren't caused from the cyst? We are almost at 4 weeks where he has more added pain in the back of his head on the right side. Even before we had the mri, he wld point to the pain on the left side. It is always in the same spot. Then we found the cyst, right where he points to. He also has a lot of pressure in his head. When it is really bad, he will hang his head upside down off the couch because he says the pressure is not as bad.
We usually have several days a week like this. Please feel free to look at his mri.
Thank you for your response.
He has horrible pain on a daily basis. I have seen two neurologists in my area and neither were very helpful. One only wanted to medicate him for his "tic". Since he has been having pain he has very frequent eye rolling and head bobbing/rolling. His eyes will also shoot to the left as well as his head will shoot to the left. I am not interested in medicating him for that at this time. How can i be sure these things aren't caused from the cyst? We are almost at 4 weeks where he has more added pain in the back of his head on the right side. Even before we had the mri, he wld point to the pain on the left side. It is always in the same spot. Then we found the cyst, right where he points to. He also has a lot of pressure in his head. When it is really bad, he will hang his head upside down off the couch because he says the pressure is not as bad.
We usually have several days a week like this. Please feel free to look at his mri.
Thank you for your response.
Brief Answer:
Cyst too small to be certain that it's the cause.
Detailed Answer:
After reviewing those images I must say that I tend to agree with your neurologists regarding the headache, that cyst shouldn't be causing headaches, it's size is contained and it doesn't lead to any raised intracranial pressure. So if it was only about the headache I would be really suspicious and consider trying medical treatment for the migraines before considering surgery.
The other symptom which should be considered is the eye rolling. The issue with that is whether it's a seizure due to the cyst or a tic. If it is a tic then of course surgery again is not necessary, but perhaps to exclude the possibility of seizures a prolonged EEG exam needs to be considered.
You can consult a neurosurgeon to ask for a second opinion, but I doubt that they will be so eager to consider intervention in a cyst of that size and that location either. Remember then arachnoid cysts are found in 2.6% of children which means they are very common and it could be that they are coincidentally found with other common issues such as headache.
I hope to have been of help.
Cyst too small to be certain that it's the cause.
Detailed Answer:
After reviewing those images I must say that I tend to agree with your neurologists regarding the headache, that cyst shouldn't be causing headaches, it's size is contained and it doesn't lead to any raised intracranial pressure. So if it was only about the headache I would be really suspicious and consider trying medical treatment for the migraines before considering surgery.
The other symptom which should be considered is the eye rolling. The issue with that is whether it's a seizure due to the cyst or a tic. If it is a tic then of course surgery again is not necessary, but perhaps to exclude the possibility of seizures a prolonged EEG exam needs to be considered.
You can consult a neurosurgeon to ask for a second opinion, but I doubt that they will be so eager to consider intervention in a cyst of that size and that location either. Remember then arachnoid cysts are found in 2.6% of children which means they are very common and it could be that they are coincidentally found with other common issues such as headache.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. You have been very helpful!
Brief Answer:
Thank you!
Detailed Answer:
I am pleased you found my opinion helpful.
Thank you for your appreciative words!
Thank you!
Detailed Answer:
I am pleased you found my opinion helpful.
Thank you for your appreciative words!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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