Arachnoid cyst natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
Prognosis of arachnoid cyst is generally excellent and is usually associated with a benign disease course, despite being symptomatic in a few patients.
Natural History
- Arachnoid cyst usually develops asymptomatically and remains asymptomatic in most patients through their lifetime;
- Most are found incidentally;
- In a few patients they may have: headaches, hydrocephalus, ataxia/gait imbalance, seizures, dizziness, visual changes, hearing loss, vertigo, nausea/vomiting, speech abnormalities, cervical myelopathy with syrinx;
- In a paper from 2013, 203 patients with arachnoid cysts were followed up, with only 5 patients presenting with enlargement of the cyst and only 2 developing symptoms that could be due to the arachnoid cyst. [1]
Complications
- Arachnoid cysts may, rarely, enlarge and complicate with the symptoms previously described such as hydrocephalus, seizures, hearing loss, visual changes and cervical myelopathy.
- In a very restricted selection of cases they may be surgically treatment, but surgery may occasionally result in complications including:
- Subdural hygroma;
- Subdural hematoma;
- Pseudomeningomyelocele;
- Subdural empyema;
- Wound complications;
- Meningitis;
- Hydrocephalus;
- Seizure;
- Need for more surgical procedures after a failed initial surgical attempt.[1]
Prognosis
- The prognosis of arachnoid cyst is often good, and in the majority of cases won't demand treatment.
- Without treatment, in a few cases the symptoms may worsen over time.
- Surgical decompression of the arachnoid cyst yielded a reduction in 66% of the patients of less than 50% of the preoperative volume. 82% were asymptomatic after the procedure, while 12% reported no relief and 6% experienced worsening of the symptoms. [2]
References
- ↑ 1.0 1.1 Al-Holou, Wajd N., et al. "Prevalence and natural history of arachnoid cysts in adults." Journal of Neurosurgery 118.2 (2013): 222-231.
- ↑ Helland, Christian A., and Knut Wester. "A population-based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in children." Journal of Neurosurgery: Pediatrics 105.5 (2006): 385-390.