Cua Dong General Hospital discovered a 28-year-old patient with a rare arachnoid cyst.

About 3 days ago, patient Hoang Hai Q. (28 years old) in Do Luong (Nghe An) had a headache from both temples spreading to the nape of the neck, pain all day and night, taking painkillers but not relieved, family took him to Cua Dong General Hospital for examination.

Associate Professor, Doctor, People's Physician Ha Hoang Kiem has discovered many rare cases of diseases, belonging to specialized fields; it is difficult for lower-level hospitals to detect and diagnose. Photo: Cao Phuong

Immediately, the patient was assigned by Professor, Doctor, People's Physician Ha Hoang Kiem to do screening tests for thyroid function, liver, kidney, diabetes and brain MRI to determine the diagnosis and find the cause of the disease.

MRI scan results of patient Q., the doctor discovered that the patient had a rare arachnoid cyst. Photo: Cao Phuong

As expected, the patient was diagnosed with a left frontal arachnoid cyst measuring 25 x 27 x 38mm and a posterior fossa arachnoid cyst measuring 23 x 24 x 50mm. Reason: The lesion in both locations had a cystic structure, the fluid in the cyst was isointense with the cerebrospinal fluid, communicated with the subarachnoid space, the cyst wall had a shell, there was no mass effect (compression) or traction, there was no localized neurological damage proving that the cerebral convolutions were preserved.

With the above characteristics, it is possible to diagnose this as an arachnoid cyst and differentiate it from other types of cysts in the brain such as encephalocele, brain fissure cyst, and glial cyst.

Associate Professor, Doctor, People's Physician Ha Hoang Kiem is currently examining and treating directly at the Professor's Clinic, Cua Dong General Hospital. Photo: Cao Phuong

According to Associate Professor, Doctor, People's Physician Ha Hoang Kiem: Arachnoid cyst is a cystic lesion, containing fluid. Cysts can be found in the brain or spinal cord, the cyst contains cerebrospinal fluid, with or very little communication with the subarachnoid space.

Symptoms of arachnoid cysts depend on the location and size of the cyst, causing compression of brain structures. There may be some nonspecific manifestations such as:

Symptoms of arachnoid cysts depend on the location and size of the cyst and often have the following clinical manifestations:

- Increased intracranial pressure: headache, nausea, vomiting, dizziness,...

- Cysts can increase in size causing symptoms of compression of cranial nerves, brain, or spinal cord.

- Epilepsy.

- Sudden clinical deterioration:

+ Due to bleeding into the cyst or subdural space: Arachnoid cysts in the middle cranial fossa often bleed due to tearing of the connecting veins.

+ Due to arachnoid cyst rupture.

If the cyst is near the midbrain fossa: Coma, seizures, visual and hearing disturbances, developmental delay, behavioral changes, inability to control voluntary movements (ataxia), loss of balance, cognitive impairment.

Regarding treatment, asymptomatic or uncomplicated arachnoid cysts may not require treatment, but their progression should be monitored periodically to intervene when necessary. Surgery is indicated for symptomatic cysts that are located close to the cortex. There is no medication to shrink the cyst. Depending on the location and size of the cyst, the cyst can be surgically removed or just opened to drain the cyst fluid into the cerebrospinal fluid using endoscopic surgery.

Therefore, if you see the above symptoms, do not ignore them but visit reputable hospitals with neurologists with full equipment to help diagnose accurately and treat effectively in a timely manner./.