Calcified congenital arachnoid cyst with heterotopic neuroglia in wall.

Abstract

ThailandS U M M A R Y Two unique findings, advanced calcification and ectopic neuroglia, were encountered in the wall of a giant congenital arachnoid cyst occurring in a 40 year old woman. The cyst almost totally filled the supratentorial subdural space of the left hemicranial cavity, was not connected with the subarachnoid space, and thus developed intra-arachnoidally. Its congenitally derived nature was supported by the unique finding of heterotopic neuroglia in the wall. Congenital arachnoid cyst must be distinguished from various cystic lesions within the central nervous system, including the neuroepithelial cyst which can arise throughout the neuraxis. It is suggested that pathogenesis of the congenital arachnoid cyst is related to aberrant flow of the ventricular cerebrospinal fluid into the developing leptomeninx in the process of differentiation of the subarachnoid space. The tract or pouch may occur within the arachnoid mater, and the cyst is formed intra-arachnoidally when the former filled with fluid is closed off from the subarachnoid space. Arachnoid cyst is rare within the cranium. Only four cysts were found among 1028 intracranial tumours in Thailand reported by Shuangshoti and Panyathanya (1974), a proportion of about 0.4% of intracranial neoplasms. We subsequently encountered an additional example of extensively calcified intracranial arachnoid cyst with ectopic neuroglia in the wall. As no reports could be traced in the medical literature of calcified arachnoid cyst and as ectopic neuroglia was present in the cyst wall, the case is reported as unique.Case report A 40 year old woman was admitted to hospital in coma. According to her son, she had had fever for four days before admission. Two days later, she complained of headache, dyspnoea, and pain in the chest. Subsequently, consciousness had deteriorated, and eventually she became comatose. The patient had had occasional headache in the past. There was no history of cranial trauma.On admission, her body temperature was 38.5°C pulse rate 140/min, respiratory rate 40/min, and

Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

“…Intracranial arachnoid cysts are often also discovered as incidental finding on imaging and make up 0.4-1% of the intracranial space occupying lesions. [ 22 23 ] The incidence of arachnoid cysts [ Figure 3 ] found in our study is comparatively higher than previous studies. [ 10 11 22 23 ] This high proportion may be due to the difficulty in distinguishing between arachnoid cysts of the suprasellar region and other benign cysts resulting in an over call as the differential diagnosis may be wide and may include Rathke cyst, third ventricular dilatation, craniopharyngioma, or epidermoid tumors.…”

Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

“…Intracranial arachnoid cysts are often also discovered as incidental finding on imaging and make up 0.4-1% of the intracranial space occupying lesions. [ 22 23 ] The incidence of arachnoid cysts [ Figure 3 ] found in our study is comparatively higher than previous studies. [ 10 11 22 23 ] This high proportion may be due to the difficulty in distinguishing between arachnoid cysts of the suprasellar region and other benign cysts resulting in an over call as the differential diagnosis may be wide and may include Rathke cyst, third ventricular dilatation, craniopharyngioma, or epidermoid tumors.…”

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

“…A 40-year-old woman was admitted to hospital in coma and died 2 days after admission [17]. Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles.…”

“…The possible maldevelopment of the roof of the fourth ventricle, which is not an entirely permeable structure, causes the generation of a diverticulum within the arachnoid membrane with entrapment of the CSF [16]. Thus, the congenital arachnoid cyst is formed intra-arachnoidally [17]. …”

“…Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles. General findings demonstrated portal cirrhosis, bilateral acute purulent pleuritis, bronchitis, pericarditis, gastromalacia, multiple small acute ulcers of the stomach and duodenum, and altered blood throughout the digestive tract [17]. …”

A large arachnoid cyst of the lateral ventricle extending from the supracerebellar cistern—case report

“…Arachnoid cysts are usually were found incidentally 0.1% to 0.4% in the general population and comprises approximately 1% of all intracranial space-occupying lesions [18][19][20]. Intraventricular arachnoid cysts were present in 4 among 54 fetal cysts diagnosed with prenatal fetal ultrasonography according to Pierre-Kahn et al [14].…”

Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

“…Intracranial arachnoid cysts are often also discovered as incidental finding on imaging and make up 0.4-1% of the intracranial space occupying lesions. [ 22 23 ] The incidence of arachnoid cysts [ Figure 3 ] found in our study is comparatively higher than previous studies. [ 10 11 22 23 ] This high proportion may be due to the difficulty in distinguishing between arachnoid cysts of the suprasellar region and other benign cysts resulting in an over call as the differential diagnosis may be wide and may include Rathke cyst, third ventricular dilatation, craniopharyngioma, or epidermoid tumors.…”

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

“…A 40-year-old woman was admitted to hospital in coma and died 2 days after admission [17]. Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles.…”

“…The possible maldevelopment of the roof of the fourth ventricle, which is not an entirely permeable structure, causes the generation of a diverticulum within the arachnoid membrane with entrapment of the CSF [16]. Thus, the congenital arachnoid cyst is formed intra-arachnoidally [17]. …”

“…Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles. General findings demonstrated portal cirrhosis, bilateral acute purulent pleuritis, bronchitis, pericarditis, gastromalacia, multiple small acute ulcers of the stomach and duodenum, and altered blood throughout the digestive tract [17]. …”

A large arachnoid cyst of the lateral ventricle extending from the supracerebellar cistern—case report

“…Arachnoid cysts are usually were found incidentally 0.1% to 0.4% in the general population and comprises approximately 1% of all intracranial space-occupying lesions [18][19][20]. Intraventricular arachnoid cysts were present in 4 among 54 fetal cysts diagnosed with prenatal fetal ultrasonography according to Pierre-Kahn et al [14].…”

Incidental cranial CT findings in head injury patients in a Nigerian tertiary hospital

“…Intracranial arachnoid cysts are often also discovered as incidental finding on imaging and make up 0.4-1% of the intracranial space occupying lesions. [ 22 23 ] The incidence of arachnoid cysts [ Figure 3 ] found in our study is comparatively higher than previous studies. [ 10 11 22 23 ] This high proportion may be due to the difficulty in distinguishing between arachnoid cysts of the suprasellar region and other benign cysts resulting in an over call as the differential diagnosis may be wide and may include Rathke cyst, third ventricular dilatation, craniopharyngioma, or epidermoid tumors.…”

Cerebellopontine Angle Arachnoid Cyst Harbouring Ectopic Neuroglia

“…A 40-year-old woman was admitted to hospital in coma and died 2 days after admission [17]. Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles.…”

“…The possible maldevelopment of the roof of the fourth ventricle, which is not an entirely permeable structure, causes the generation of a diverticulum within the arachnoid membrane with entrapment of the CSF [16]. Thus, the congenital arachnoid cyst is formed intra-arachnoidally [17]. …”

“…Necropsy findings showed a partially calcified arachnoid cyst with ectopic neuroglia in the wall filling the supratentorial subdural space from the frontal to the occipital poles. General findings demonstrated portal cirrhosis, bilateral acute purulent pleuritis, bronchitis, pericarditis, gastromalacia, multiple small acute ulcers of the stomach and duodenum, and altered blood throughout the digestive tract [17]. …”

A large arachnoid cyst of the lateral ventricle extending from the supracerebellar cistern—case report

“…Arachnoid cysts are usually were found incidentally 0.1% to 0.4% in the general population and comprises approximately 1% of all intracranial space-occupying lesions [18][19][20]. Intraventricular arachnoid cysts were present in 4 among 54 fetal cysts diagnosed with prenatal fetal ultrasonography according to Pierre-Kahn et al [14].…”