Acute Onset of Psychosis in a Patient with a Left Temporal Lobe Arachnoid Cyst

Abstract

Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. A 38-year-old Haitian American female with no past psychiatric history presented with rapid onset of psychosis. Workup for medical etiology proved to be within normal limits, with the exception of a left temporal lobe arachnoid cyst. The purpose of this paper is to add to a number of existing case reports that suggest a relationship between such lesions and psychiatric illness.

Cut it out or wait it out? Case series of middle fossa arachnoid cysts presenting with psychiatric symptoms and a discussion of the ethics of neurosurgical management

“…Middle fossa arachnoid cysts have been associated with psychiatric symptoms. 3 4 7–10 Causality can be inferred by temporal lobe pathology in neuropsychiatric conditions, such as psychosis in relation to TLE. 12 This is underlined by reports of the resolution of psychiatric symptoms following arachnoid cyst surgery.…”

“… 12 This is underlined by reports of the resolution of psychiatric symptoms following arachnoid cyst surgery. 3 …”

“…There have also been studies that failed to show neuropsychological differences in patients with arachnoid cysts 11 and case reports where psychiatric treatment, as usual, leads to predictable symptomatic improvement. 3 Improved understanding of the mechanisms by which cysts might contribute to symptoms is, therefore, necessary to aid decision-making.…”

A population study of Norwegian psychiatric patients referred for clinical brain scanning

“…In patients with psychosis, we found 1.9% had cysts as the main pathology. In the literature, five case reports are published on the topic of arachnoid cysts in patients with psychosis 25 – 29 , but there are no cohort studies showing increased prevalence of arachnoid cysts in psychosis. In the neuroradiologic textbook by Osborne, arachnoid cyst prevalence is reported to be 1–2%, indicating that our result does not represent an increased prevalence of arachnoid cysts in patients with psychosis.…”

Psychosis and iddle cranial fossa arachnoid cyst: Case report and literature review

“…Besides, in its extreme it can lead to a syndrome of Kluver and Bucy (Kiernan, 2012;Hoesen, 1995). Hence the anatomical association between psychosis and middle cranial fossa lesions, especially arachnoid cyst, is established, but its causation needs to be elucidated (Blackshaw & Bowen 1987;da Silva et al, 2007;Mironov et al, 2014;Bahk et al, 2002;Das et al, 2017;Vakis et al, 2006;Maner et al, 2014).…”