1
|
Qureshi HM, Mekbib KY, Allington G, Elsamadicy AA, Duy PQ, Kundishora AJ, Jin SC, Kahle KT. Familial and syndromic forms of arachnoid cyst implicate genetic factors in disease pathogenesis. Cereb Cortex 2023; 33:3012-3025. [PMID: 35851401 PMCID: PMC10388392 DOI: 10.1093/cercor/bhac257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/13/2022] Open
Abstract
Arachnoid cysts (ACs) are the most common space-occupying lesions in the human brain and present significant challenges for clinical management. While most cases of ACs are sporadic, nearly 40 familial forms have been reported. Moreover, ACs are seen with increased frequency in multiple Mendelian syndromes, including Chudley-McCullough syndrome, acrocallosal syndrome, and autosomal recessive primary ciliary dyskinesia. These findings suggest that genetic factors contribute to AC pathogenesis. However, traditional linkage and segregation approaches have been limited in their ability to identify causative genes for ACs because the disease is genetically heterogeneous and often presents asymptomatically and sporadically. Here, we comprehensively review theories of AC pathogenesis, the genetic evidence for AC formation, and discuss a different approach to AC genomics that could help elucidate this perplexing lesion and shed light on the associated neurodevelopmental phenotypes seen in a significant subset of these patients.
Collapse
Affiliation(s)
- Hanya M Qureshi
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Kedous Y Mekbib
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Garrett Allington
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Aladine A Elsamadicy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Phan Q Duy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Adam J Kundishora
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
| | - Sheng Chih Jin
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Kristopher T Kahle
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, United States
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA 02115, United States
- Department of Neurology, Harvard Medical School, Boston, MA 02115, United States
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, United States
| |
Collapse
|
2
|
Gale JR, Nowicki KW, Wolfe RM, Sefcik RK, Abel TJ. Infection of arachnoid cyst associated with vasospasm and stroke in a pediatric patient: case report. J Neurosurg Pediatr 2020; 26:594-598. [PMID: 32858508 DOI: 10.3171/2020.5.peds20419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/06/2022]
Abstract
Arachnoid cysts are relatively common and benign intraarachnoid membrane outpouchings containing CSF-like fluid. The majority of arachnoid cysts remain stable and asymptomatic and do not require intervention in the pediatric population. Here, the authors present the first reported case of an infected arachnoid cyst in a pediatric patient resulting in severe vasospasm of the left terminal internal carotid artery, left A1 segment, and left M1 branches with a left middle cerebral artery infarct. Their experience suggests that close monitoring is warranted for this condition and that the pediatric population may be at higher risk for vasospasm.
Collapse
Affiliation(s)
- Jenna R. Gale
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kamil W. Nowicki
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rachel M. Wolfe
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Roberta K. Sefcik
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Taylor J. Abel
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| |
Collapse
|
3
|
Abstract
INTRODUCTION Arachnoid cysts are commonly considered congenital lesions, but this has not been proven. With the development of neuroimaging and DNA testing technology, more cases of familial arachnoid cysts have been reported. Herein, we review such cases. MATERIALS AND METHODS The PubMed, Embase, and Web of Science databases were searched for case reports of arachnoid cysts published through April 2018. Case reports were included only if two or more related patients were diagnosed with an arachnoid cyst by neuroimaging or intraoperatively. For each report, the following data were extracted: first author name, date of publication, number of families, number of patients, location of the arachnoid cysts, patient age, patient sex, and genetic mutations and associated disease. RESULTS Our searches identified 33 case reports involving 35 families and 115 patients. The locations of arachnoid cysts were similar in 25 of the 35 families. Spinal extradural arachnoid cysts were reported most often, followed by arachnoid cysts in the middle fossa and posterior fossa. A left-sided predominance was noticed for arachnoid cysts of the middle fossa. Mutation of the FOXC2 gene was reported most often, and arachnoid cysts may be associated with mutations on chromosome 16. CONCLUSIONS Although the origin of arachnoid cysts is believed to have a genetic component by some researchers, the genes associated with arachnoid cysts remain unknown. Unfortunately, the evidence remains insufficient.
Collapse
|
4
|
Yahal O, Katorza E, Zvi E, Berkenstadt M, Hoffman C, Achiron R, Bar-Yosef O. Prenatal diagnosis of arachnoid cysts: MRI features and neurodevelopmental outcome. Eur J Radiol 2019; 113:232-237. [PMID: 30927952 DOI: 10.1016/j.ejrad.2019.02.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/20/2019] [Accepted: 02/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Arachnoid cysts (AC) are congenital lesions comprising 1% of all intracranial mass lesions. The aim of this study was to characterize arachnoid cysts and their neurodevelopmental outcome and to compare it with the outcome of children without AC. METHODS This is a retrospective cohort study of arachnoid cysts detected prenatally by fetal MRI in 29 fetuses compared to a control group of 59 fetuses without arachnoid cyst who were examined by MRI. The cohort was investigated from two different angles: anatomical and developmental. Anatomical analyzation, the cohort was divided into 2 groups by the arachnoid cyst anatomical location: group A (n = 9), which included cases with supratentorial cyst, and group B (n = 20), which included cases with infratentorial cyst. Developmental analyzation, the cohort was divided into 2 groups by the neurodevelopmental outcome: group γ (n = 5) which included cases that were affected by arachnoid cyst presence, and group δ (n = 17) which included cases that had neurodevelopmental outcome within the normal range. Data collected included prenatal history, MRI features, sonographic follow up, and neurodevelopmental outcome. RESULTS In 22/29 cases we achieved a long-term follow up, by evaluation of children development in a range of ages from 6 months to 6 years. In group A (n = 9), 4 infants had normal outcome, 2 had abnormal outcome, 1 pregnancy was terminated, and 2 cases were not cooperative with the study. In group B (n = 20), 13 infants had normal outcome, 3 had abnormal outcome, and 4 cases were not cooperative with the study. CONCLUSIONS From all cases with AC detected by fetal MRI, 77.3% had normal neurodevelopmental outcome and 22.7% had abnormal neurodevelopment.
Collapse
Affiliation(s)
- Orr Yahal
- Department of Pediatric Neurology, Sheba Medical Center, Tel Hashomer, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
| | - Eldad Katorza
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Antenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Elad Zvi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Berkenstadt
- Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Chen Hoffman
- Antenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; Neuroradiology Unit, Department of Diagnostic Radiology, Sheba Medical Center, Tel Hashomer, Israel
| | - Reuven Achiron
- Antenatal Diagnostic Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Omer Bar-Yosef
- Department of Pediatric Neurology, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
5
|
Furey CG, Timberlake AT, Nelson-Williams C, Duran D, Li P, Jackson EM, Kahle KT. Xp22.2 Chromosomal Duplication in Familial Intracranial Arachnoid Cyst. JAMA Neurol 2019; 74:1503-1504. [PMID: 29052703 DOI: 10.1001/jamaneurol.2017.3399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Charuta G Furey
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Andrew T Timberlake
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut.,Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, Connecticut
| | | | - Daniel Duran
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Peining Li
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Eric M Jackson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristopher T Kahle
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
6
|
Boronat S, Caruso P, Auladell M, Van Eeghen A, Thiele EA. Arachnoid cysts in tuberous sclerosis complex. Brain Dev 2014; 36:801-6. [PMID: 24325802 DOI: 10.1016/j.braindev.2013.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/22/2013] [Accepted: 11/12/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Some clinical findings in tuberous sclerosis complex (TSC), such as hypomelanotic macules or angiofibromas are related to problems in development of the neural crest, which is also the origin of cranial leptomeninges. Arachnoid cysts have been reported in two TSC patients to date. The purpose of this study was to assess the prevalence and characteristics of arachnoid cysts in a large cohort of TSC. MATERIALS AND METHOD We performed a review of brain MRIs of 220 TSC patients searching for arachnoid cysts. RESULTS Arachnoid cysts were found in 12 (5.5%) (general population: 0.5%), including ten males (83.3%). Four patients (33.3%) had also autosomal dominant polycystic kidney disease (ADPKD) due to a contiguous deletion of the TSC2-PKD1 genes. Three patients (25%) had two or more arachnoid cysts, of whom two also had ADPKD. One patient with an arachnoid cyst did not have tubers, subependymal nodules or white matter migration lines. CONCLUSION Our study suggests that arachnoid cysts are part of the clinical spectrum of TSC and may be also present in TSC patients without other typical TSC brain lesions.
Collapse
Affiliation(s)
- Susana Boronat
- Department of Neurology, Massachusetts General Hospital, Boston, USA; Department of Pediatric Neurology, Vall d' Hebron Hospital, Universitat Autònoma de Barcelona, Spain
| | - Paul Caruso
- Department of Neuroradiology, Massachusetts General Hospital, Boston, USA
| | - Maria Auladell
- Department of Neurology, Massachusetts General Hospital, Boston, USA
| | - Agnies Van Eeghen
- Department of Neurology, Massachusetts General Hospital, Boston, USA
| | | |
Collapse
|
7
|
Rabiei K, Tisell M, Wikkelsø C, Johansson BR. Diverse arachnoid cyst morphology indicates different pathophysiological origins. Fluids Barriers CNS 2014; 11:5. [PMID: 24581284 PMCID: PMC4078003 DOI: 10.1186/2045-8118-11-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 02/03/2014] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND There are few, limited, and to some extent contradictory, reports on the cellular and subcellular morphology of arachnoid cysts. In the literature cyst membranes are described as similar to, or as vastly different from, normal arachnoid membranes. METHODS This paper reports electron microscopic analyses of symptomatic cysts from 24 patients (12 males and 12 females; age 10-79), that underwent fenestration surgery. Fourteen cysts were located in the middle cranial fossa (temporal), one in the interpeduncular cistern, five in the posterior fossa, and four were overlying the frontal cortex. RESULTS Microscopic findings confirmed the diverse nature of this clinical condition. Twelve cyst walls resembled normal arachnoid, four had a conspicuous core of dense fibrous tissue with a simple epithelial lining, and the remaining aberrant cysts exhibited non-arachnoid luminal epithelia with plentiful microvilli and/or cilia, and also nervous tissue components in the wall. The possible identity and origin of various cyst types are discussed. We hypothesize that cysts are formed mostly at an early stage of embryonic development, as a teratological event. CONCLUSIONS Cysts with various epithelial linings and extracellular components most likely have different barrier properties and fluid turnover characteristics. Further studies are needed to elucidate relations between cyst morphology, fluid composition, pathogenesis, and clinical behaviour including growth rate and relapse tendency.
Collapse
Affiliation(s)
- Katrin Rabiei
- Institute of Neuroscience and Physiology, c/o Neurosurgical Clinic, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden.
| | | | | | | |
Collapse
|
8
|
Özek MM, Urgun K. Neuroendoscopic Management of Suprasellar Arachnoid Cysts. World Neurosurg 2013; 79:S19.e13-8. [DOI: 10.1016/j.wneu.2012.02.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 02/02/2012] [Indexed: 11/25/2022]
|
9
|
The intracranial arachnoid mater : a comprehensive review of its history, anatomy, imaging, and pathology. Childs Nerv Syst 2013; 29:17-33. [PMID: 22961357 DOI: 10.1007/s00381-012-1910-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 08/27/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The arachnoid mater is a delicate and avascular layer that lies in direct contact with the dura and is separated from the pia mater by the cerebrospinal fluid-filled subarachnoid space. The subarachnoid space is divided into cisterns named according to surrounding brain structures. METHODS The medical literature on this meningeal layer was reviewed in regard to historical aspects, etymology, embryology, histology, and anatomy with special emphasis on the arachnoid cisterns. Cerebrospinal fluid dynamics are discussed along with a section devoted to arachnoid cysts. CONCLUSION Knowledge on the arachnoid mater and cerebrospinal fluid dynamics has evolved over time and is of great significance to the neurosurgeon in clinical practice.
Collapse
|
10
|
Bayrakli F, Okten AI, Kartal U, Menekse G, Guzel A, Oztoprak I, Pinarbasi E, Kars HZ. Intracranial arachnoid cyst family with autosomal recessive trait mapped to chromosome 6q22.31-23.2. Acta Neurochir (Wien) 2012; 154:1287-92. [PMID: 22389037 DOI: 10.1007/s00701-012-1312-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 02/15/2012] [Indexed: 12/19/2022]
Abstract
BACKGROUND Arachnoid cysts are congenital fluid-filled compartments within the cerebrospinal fluid cisterns and cerebral fissures. They most commonly occur sporadically, and familial occurrence has rarely been reported. In this study, we showed the first genetic linkage in the literature in a pure intracranial arachnoid cyst family with autosomal recessive trait. METHODS We identified an intracranial arachnoid cyst family in southern Turkey whose six of seven offspring had intracranial arachnoid cysts in different localizations, and collected venous blood from seven offspring of the family. Whole-genome linkage analysis was performed in all offspring. RESULTS A theorical maximum logarithm of the odds score of 4.6 was identified at chromosome 6q22.31-23.2. This result shows strong genetic linkage to this locus. CONCLUSIONS We present the first genetic linkage analysis result in a pure intracranial arachnoid cyst family in literature. Further investigation of this linkage area can reveal a causative gene causing the intracranial arachnoid cyst phenotype and can illuminate the pathogenesis of this disease.
Collapse
Affiliation(s)
- Fatih Bayrakli
- Department of Neurosurgery, Cumhuriyet University School of Medicine, Kampus, Merkez, Sivas, Turkey, 58140.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Abstract
Arachnoid cysts are fluid-filled duplications or splittings of the arachnoid layer with a content which is similar but not equal to the cerebrospinal fluid. Arachnoid cysts are not actual neurodegenerative disorders, rather the underlying defect of the texture of the arachnoid layer is probably congenital in nature. They can occur sporadically or can be associated with other malformations or diseases. Arachnoid cysts may be discovered in early childhood. However, they can develop de novo, grow or decrease in size. They may be diagnosed by ultrasound screening in the fetal period or be discovered during childhood or adulthood. Many arachnoid cysts are asymptomatic.Treatment strategies are discussed controversially. If they are diagnosed incidentally or are correlated with only very mild symptoms, a conservative management with follow-up imaging may be favored. If they grow, they can cause headaches, seizures or other neurological symptoms and require neurosurgical treatment. This chapter addresses aspects of pathogenesis, clinical symptoms, indication for neurosurgical treatment and treatment options.
Collapse
|
12
|
Helland CA, Lund-Johansen M, Wester K. Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. J Neurosurg 2010; 113:934-9. [DOI: 10.3171/2009.11.jns081663] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The aim of this study was to examine the distribution of intracranial arachnoid cysts in a large and unselected patient population with special emphasis on sidedness and sex distribution.
Methods
In total, 299 patients with 305 arachnoid cysts were studied. These patients were consecutively referred to our department during a 20-year period from a well-defined geographical area with a stable population.
Results
There was a strong predilection (198 patients [66.2%]) for intracranial arachnoid cysts in the temporal fossa. Forty-two patients had cysts overlying the frontal convexity, 36 had cysts in the posterior fossa, and 23 patients had cysts in other, different locations. Of 269 cysts with clearly unilateral distribution, 163 were located on the left side and 106 on the right side. This difference resulted from the marked preponderance of temporal fossa cysts on the left side (left-to-right ratio 2.5:1; p < 0.0001 [adjusted < 0.0005]). For cysts in the cerebellopontine angle (CPA), there was preponderance on the right side (p = 0.001 [adjusted = 0.005]). Significantly more males than females had cysts in the temporal fossa (p = 0.002 [adjusted = 0.004]), whereas in the CPA a significant female preponderance was found (p = 0.016 [adjusted = 0.032]). For all other cyst locations, there was no difference between the 2 sexes.
Conclusions
Arachnoid cysts have a strong predilection for the temporal fossa. There is a sex dependency for some intracranial locations of arachnoid cysts, with temporal cysts occurring more frequently in men, and CPA cysts found more frequently in women. Furthermore, there is a strong location-related sidedness for arachnoid cysts, independent of patient sex. These findings and reports from the literature suggest a possible genetic component in the development of some arachnoid cysts.
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW The present review summarizes the current theories on arachnoid cyst formation, the common presentations of cysts surrounding or eroding the temporal bone from the middle and posterior cranial fossae, the diagnostic strategies and the management considerations and options. RECENT FINDINGS Arachnoid cysts are most common in the middle cranial fossa and rarely present in association with the petrous apex. They are frequently found incidentally on imaging studies performed in the workup for unrelated symptoms. When they do cause symptoms, these are usually nonspecific. Thus it is important to establish the relationship between the two. Peripetrosal arachnoid cysts may cause cranial nerve deficits in addition to symptoms related to intracranial hypertension. Small asymptomatic cysts are managed conservatively with serial imaging. Large symptomatic cysts are often managed surgically with shunting, open excision or open or neuroendoscopic fenestration or marsupialization. The management of large asymptomatic cysts depends on the patient and cyst characteristics. SUMMARY Peripetrosal arachnoid cysts are often incidental findings. Careful selection of surgical candidates is of utmost importance. Multiple surgical options with similar success rates are available. The rates and profile of their complications may differ. Overall, approximately 70% of patients experience improvement in their symptoms with surgery.
Collapse
Affiliation(s)
- Ricardo Cristobal
- Otology, Neurotology, and Skull Base Surgery, Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
| | | |
Collapse
|
14
|
Guzel A, Tatli M, Bilguvar K, Diluna ML, Bakkaloglu B, Ozturk AK, Bayrakli F, Gunel M. Apparently novel genetic syndrome of pachygyria, mental retardation, seizure, and arachnoid cysts. Am J Med Genet A 2007; 143A:672-7. [PMID: 17343267 DOI: 10.1002/ajmg.a.31640] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We report on an apparently new syndrome in a consanguineous family with seven members, three of whom have cerebral anomalies including pachygyria and arachnoid cysts along with mental retardation and seizures. The two patients with seizure disorders also had multiple enlarged perivascular spaces seen in the white matter of the centrum semiovale. Our data provide a contribution to the accumulating knowledge on familial cerebral anomalies including arachnoid cysts and lissencephaly. Given the lack of mutation in known lissencephaly genes such as LIS1, 14-3-3epsilon, and DCX, this syndrome may constitute a new phenotype with autosomal recessive inheritance.
Collapse
Affiliation(s)
- Aslan Guzel
- Department of Neurosurgery, Dicle University, Diyarbakir, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Epelman M, Daneman A, Blaser SI, Ortiz-Neira C, Konen O, Jarrín J, Navarro OM. Differential Diagnosis of Intracranial Cystic Lesions at Head US: Correlation with CT and MR Imaging. Radiographics 2006; 26:173-96. [PMID: 16418251 DOI: 10.1148/rg.261055033] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The differential diagnosis of intracranial cystic lesions at head ultrasonography (US) includes a broad spectrum of conditions: (a) normal variants, (b) developmental cystic lesions, (c) cysts due to perinatal injury, (d) vascular cystlike structures, (e) hemorrhagic cysts, and (f) infectious cysts. These lesions vary in prevalence from common (cavum of the septum pellucidum, subependymal cyst, choroid plexus cyst) to rare (vein of Galen malformation). US can provide important information about the anatomic location, size, and shape of the lesions as well as their mass effect on adjacent structures. Differential diagnosis may be difficult because there is substantial overlap of US features between many of these conditions. However, if careful attention is paid to the location and characteristics of the cyst, a more specific diagnosis may be suggested. Understanding the spectrum of appearances of the various intracranial cystic lesions at head US improves the diagnostic yield, enables one to understand their pathogenesis, and facilitates patient care.
Collapse
Affiliation(s)
- Monica Epelman
- Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
| | | | | | | | | | | | | |
Collapse
|
16
|
Arriola G, de Castro P, Verdú A. Familial arachnoid cysts. Pediatr Neurol 2005; 33:146-8. [PMID: 16087064 DOI: 10.1016/j.pediatrneurol.2005.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Revised: 12/16/2004] [Accepted: 02/22/2005] [Indexed: 11/16/2022]
Abstract
Arachnoid cysts are a relatively common incidental finding on neuroimaging studies of the brain. Although most cases are sporadic, there have been some reports of arachnoid cysts in several members of the same family. This report describes two additional families with three members affected in each one. Both families had members with arachnoid cysts in two consecutive generations. In one of the families, arachnoid cysts were associated with a deletion in the long arm of chromosome 16, an association not described previously. These descriptions suggest that in some cases arachnoid cysts may have a genetic basis.
Collapse
Affiliation(s)
- Gema Arriola
- Pediatric Neurology Section, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | |
Collapse
|
17
|
Chao TK. Middle cranial fossa arachnoid cysts causing sensorineural hearing loss. Eur Arch Otorhinolaryngol 2005; 262:925-7. [PMID: 15891926 DOI: 10.1007/s00405-005-0921-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Accepted: 12/19/2004] [Indexed: 11/25/2022]
Abstract
Arachnoid cyst of the middle cranial fossa has never been reported to present with sensorineural hearing impairment. We report the case of a 15-year-old girl who complained of progressive hearing loss on the right side for 4 years. The pure tone audiometry revealed sensorineural hearing loss with an average of 63 dB, and the auditory brain stem response demonstrated absence of all waves on the right side. Magnetic resonance imaging showed giant arachnoid cysts occupying the bilateral middle cranial fossa and extending to the parietal and prepontine areas with the atrophic change of the right facial-acoustic nerve cord and a decrease in signal intensity of the right cochlea and vestibule. The cystoperitoneal shunting procedure was suggested, but the parents hesitated about the surgical treatment. The patient has not received any surgical intervention, and her hearing has been stable for 1 year during the follow-up period. This case represents the first report that sensorineural hearing loss is a possible presenting symptom when arachnoid cysts of the middle cranial fossa are massive.
Collapse
Affiliation(s)
- Ting-Kuang Chao
- Department of Otolaryngology, Far Eastern Memorial Hospital, Pan-Chiao, Taipei, Taiwan.
| |
Collapse
|
18
|
Abstract
Cerebral arachnoid cysts that occur in more than one member of a family have been rarely reported. These familial cases are important because they imply a genetic component in the pathophysiology of these arachnoid cysts. We present an unusual family in which two conditions, a genetic myopathy, oculopharyngeal muscular dystrophy (OPMD), and arachnoid cysts occur together. OPMD is caused by a mutation in the PAPB2 gene that localizes to chromosome 14. In this family, two siblings with genetically confirmed OPMD both have left hemispheric intracranial arachnoid cysts unassociated with other cerebral abnormalities. The association of these two disorders suggests that in this family, a chromosome 14 gene may play a role in the development of arachnoid cysts.
Collapse
Affiliation(s)
- K J Jadeja
- Laboratory of Neurogenetics, New Jersey Neuroscience Institute/JFK Medical Center, Edison, NJ 08818, USA
| | | |
Collapse
|
19
|
Suzuki H, Takanashi JI, Sugita K, Barkovich AJ, Kohno Y. Retrocerebellar arachnoid cysts in siblings with mental retardation and undescended testis. Brain Dev 2002; 24:310-3. [PMID: 12142070 DOI: 10.1016/s0387-7604(02)00061-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Arachnoid cysts comprise approximately 1% of all intracranial space-occupying lesions and usually occur sporadically. We report retrocerebellar arachnoid cysts in two male siblings with mental retardation and undescended testis, suggesting the possibility of a genetic basis for at least some cases of retrocerebellar arachnoid cysts.
Collapse
Affiliation(s)
- Hiroko Suzuki
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | | | | | | |
Collapse
|
20
|
Hendriks Y, Laan L, Vielvoye G, van Haeringen A. Bilateral sensorineural deafness, partial agenesis of the corpus callosum, and arachnoid cysts in two sisters. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/(sici)1096-8628(19990910)86:2<183::aid-ajmg19>3.0.co;2-u] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
21
|
Tolmie JL, Day R, Fredericks B, Galea P, Moffett AW. Dominantly inherited cerebral dysplasia: arachnoid cyst associated with mild mental handicap in a mother and her son. J Med Genet 1997; 34:1018-20. [PMID: 9429147 PMCID: PMC1051156 DOI: 10.1136/jmg.34.12.1018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a mother and son who each presented in infancy with hypotonia and global developmental delay. Subsequently, in both subjects, mild mental handicap was diagnosed in association with temporal lobe arachnoid cysts. Mendelian inheritance of this phenotype seems likely and macroscopic cerebral dysplasia in general may be underdiagnosed in people with familial, mild mental handicap.
Collapse
Affiliation(s)
- J L Tolmie
- Duncan Guthrie Institute of Medical Genetics, Yorkhill Hospitals NHS Trust, Glasgow, UK
| | | | | | | | | |
Collapse
|
22
|
Cole WG, Lam TP. Arachnoid cyst and chronic subdural haematoma in a child with osteogenesis imperfecta type III resulting from the substitution of glycine 1006 by alanine in the pro alpha 2(I) chain of type I procollagen. J Med Genet 1996; 33:193-6. [PMID: 8728690 PMCID: PMC1051866 DOI: 10.1136/jmg.33.3.193] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The features of a child with osteogenesis imperfecta type III (OI III) resulting from the heterozygous substitution of glycine 1006 by alanine in the pro alpha 2(I) chain of type I procollagen were studied. He was born at term with the clinical features of severe OI, including deep grey-blue sclerae. He had severe osteopenia and all long bones were smaller than normal with cortical thinning, metaphyseal expansion, poor metaphyseal modelling, and multiple fractures. However, the vertebrae, pelvis, and shoulder girdle were of normal shape and there were few rib fractures. Histological examination of the calvarium and tibial shaft showed woven bone without lamellar bone or Haversian systems. The shafts of the long bones were widened owing to repeated fractures. Progressive enlargement of the calvarium occurred between 3 and 4.5 months of age owing to bilateral chronic subdural haematomata and a large arachnoid cyst in the Sylvian fissure. The cyst was probably developmental in origin while the subdural collections were probably the result of perinatal skull trauma. The cyst and the subdural collections resolved following drainage but ventricular dilatation with normal cerebrospinal fluid pressure followed. The proband is the first reported case of OI with a glycine substitution by alanine in the pro alpha 2(I) chain of type I procollagen.
Collapse
Affiliation(s)
- W G Cole
- Centre for the Study of Heritable Connective Tissue Disorders, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | |
Collapse
|
23
|
Aiba T, Koike T, Takeda N, Tanaka R. Intracranial cavernous malformations and skin angiomas associated with middle fossa arachnoid cyst: a report of three cases. SURGICAL NEUROLOGY 1995; 43:31-3; discussion 34. [PMID: 7701419 DOI: 10.1016/0090-3019(95)80034-e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Three cases of multiple intracranial cavernous malformations and skin angioma associated with middle fossa arachnoid cyst are reported. Though no relation was confirmed in the pathogenesis of these lesions, this combination could be a new entity of neurocutaneous phacomatosis.
Collapse
Affiliation(s)
- T Aiba
- Department of Neurosurgery, Niigata University, Japan
| | | | | | | |
Collapse
|
24
|
Abstract
The occurrence of bilateral temporal arachnoid cysts has been considered as a rare event. Unilateral arachnoid pouches have been reported in a few instances associated with neurofibromatosis. The authors describe a 5-year-old girl with bilateral temporal arachnoid cysts who presented obvious stigmata of van Recklinghausen's disease. To the best of our knowledge, this is the first time that this association has been described in the literature.
Collapse
Affiliation(s)
- J F Martínez-Lage
- Regional Service of Neurosurgery, Virgen de Arrixaca University Hospital, Murcia, Spain
| | | | | |
Collapse
|