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Arachnoid Cysts: Spontaneous Resolution Distinct From Traumatic Rupture

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Arachnoid Cysts: Spontaneous Resolution Distinct From Traumatic Rupture

Abstract and Introduction

Abstract


Although many arachnoid cysts are discovered incidentally and require no intervention, a small subset has been known to rupture. Note that rupture can occur either spontaneously or in association with trauma. Based on a review of the literature on ruptured arachnoid cysts, it appears that patients with middle fossa cysts are more likely to experience symptomatic traumatic rupture than those with cysts in other locations. Middle fossa cysts are more commonly associated with hemispheric subdural collections and hematomas than are any other cysts. The authors report on two representative cases illustrating the distinct presentation, imaging characteristics, and management of these cysts.

Introduction


Many Arachnoid Cysts are discovered incidentally in patients with minor head trauma, headache, or symptoms from another lesion. Symptoms can develop as cysts grow and exert mass effect on surrounding structures. However, many cysts remain asymptomatic, and thus their treatment remains controversial. In patients who do not receive treatment, spontaneous resolution has been reported with and without trauma. Minor trauma can be associated with asymptomatic resolution of a cyst, but moderate head trauma can result in subdural effusions with intracranial hypertension. Cysts in the middle fossa, cerebral convexity, and suprasellar, supracerebellar, and prepontine regions have been reported to resolve spontaneously and asymptomatically. In contrast, patients with traumatic symptomatic rupture are more likely to have middle fossa cysts.

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