Recurrent Arachnoid Cyst of Meckel’s Cave Mimicking a Brain Stem Ischaemia. Report of a Rare Case

Wörner, Bertold; Noll, Markus; Rahim, Tania; Fink, U.; Oeckler, R.

doi:10.1055/s-2003-40376

Cited by 8 publications

(1 citation statement)

References 18 publications

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“…1 Such cranial nerve palsies have been reported in association with arachnoid cysts in the interpeduncular cistern, 3 middle cranial fossa, 4 cavernous sinus, 5 suprasellar cistern, 6 and Meckel's cave. 7 The clinical features and neuroimaging of crural cistern arachnoid cysts are not well defined in the current literature. 8 The crural cistern is located in the ventrolateral area of the midbrain in the region adjacent to the cerebral peduncle and parahippocampal gyrus.…”

Section: Discussionmentioning

confidence: 99%

Arachnoid Cyst Causing an Oculomotor Nerve Palsy in a Pediatric Patient: A Case Report

Hennein

Rasool

Indaram

2020

Journal of Pediatric Neurology

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An arachnoid cyst causing a compressive oculomotor nerve palsy is rare in the pediatric population. We describe a case of an acquired, partial oculomotor nerve palsy in a 3-year-old boy caused by an arachnoid cyst in the left crural cistern with associated amblyopia. The patient's amblyopia was aggressively treated, and he underwent cyst fenestration. Two months postoperatively, he continued to demonstrate a partial oculomotor palsy with improved visual acuity and recurrence of the cyst. This case demonstrates that cyst fenestration may not always resolve these paretic effects, cysts may recur after fenestration, and amblyopia must be treated in this setting.

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Section: Discussionmentioning

confidence: 99%

Arachnoid Cyst Causing an Oculomotor Nerve Palsy in a Pediatric Patient: A Case Report

Hennein

Rasool

Indaram

2020

Journal of Pediatric Neurology

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Trigeminal neuropathy associated with an enlarging arachnoid cyst in Meckel’s cave: case report, management strategy and review of the literature

2017

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We describe a rare case and novel management strategy of painful trigeminal neuropathy caused by an arachnoid cyst confined to Meckel's cave. A 57-year-old female presented with several years of progressive trigeminal pain and signs of trigeminal deafferentation, including sensory loss, corneal anesthesia and mastication muscle atrophy. Medical treatment with carbamazepine provided partial and temporary pain control. Surgical treatment was eventually performed by aspiration of the arachnoid cyst through the foramen ovale using a percutaneous approach. The patient experienced relief of pain and improvement of numbness and muscle strength. To our knowledge, this is the first case description of a percutaneous drainage of a Meckel's cave arachnoid cyst.

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Access to Meckel’s cave for biopsies of indeterminate lesions: a systematic review

et al. 2020

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Accessing Meckel's cave (MC) is surgically challenging. Open approaches are complex and often correlated with high morbidity. Endoscopic approaches emerged in the last decade as feasible alternatives to open approaches, especially for sampling indeterminate lesions. This article first analyses available routes to approach Meckel's cave and presents furthermore an illustrative case. We conducted a systematic review and reported according to the guidelines for preferred reporting items for systematic reviews and meta-analyses (PRISMA). Various surgical approaches identified through the search are evaluated and discussed in detail. Additionally, we report on a case of woman with a lesion in MC, which was accessed through an endoscopic transpterygoid approach subsequently diagnosed as a diffuse large B cell lymphoma. Our search delivered 75 articles that included case reports (n = 21), cadaveric studies (n = 32), clinical articles (n = 16), review of the literatures (n = 3), as well as technical notes (n = 2) and a radiological manuscript (n = 1). Open routes included lateral approaches with many variations, mainly intra-and extradural pterional approaches and anterior petrosal, as well as a retrosigmoid intradural suprameatal and a lateral transorbital approach. Endoscopically, MC was reached via approaches that included transpterygoid, transorbital or infraorbital fissure routes. Percutaneous approaches, e.g. through the foramen ovale, were also described. Multiple surgical approaches to MC are currently available. Their different characteristics as well as individual patient factors, such as clinical history and the localization of the disease, have to be considered when choosing a surgical corridor. Studies included in this review highlight the endonasal endoscopic transpterygoidal technique as an excellent corridor for biopsies in the ventral MC.

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Recurrent Arachnoid Cyst of Meckel’s Cave Mimicking a Brain Stem Ischaemia. Report of a Rare Case

Abstract: An arachnoidal cyst must be considered as a rare cause, when a lesion is found at the Meckel's cave with intermittent clinical symptoms of a trigeminal nerve affection. As surgical treatment we favour fenestration and cyst wall resection.

Cited by 8 publications

References 18 publications

Arachnoid Cyst Causing an Oculomotor Nerve Palsy in a Pediatric Patient: A Case Report

Arachnoid Cyst Causing an Oculomotor Nerve Palsy in a Pediatric Patient: A Case Report

Trigeminal neuropathy associated with an enlarging arachnoid cyst in Meckel’s cave: case report, management strategy and review of the literature

Access to Meckel’s cave for biopsies of indeterminate lesions: a systematic review

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