Arachnoid Cysts of the Brain and Spine

Arachnoid cysts are one of five types of cysts which can form in the brain. They are so-named
because they are located between the brain and arachnoid membrane, the middle of three
membranes which surround the brain and spinal cord.
Arachnoid cysts may also be found along the spine. Neither arachnoid cysts of the brain nor
arachnoid cysts of the spine should be confused with arachnoiditis (inflammation of the arachnoid
membrane), although both conditions may present in some patients.
What Causes Arachnoid Cysts?
Most arachnoid cysts are primary, meaning they form during fetal development and are therefore
present at birth. Less common are secondary arachnoid cysts which result later in life from trauma,
meningitis, tumors or complications of surgery. Both forms are regarded as rare neurological
conditions. Arachnoid cysts occur much more often in males than females.

Is an Arachnoid Brain Cyst a Type of Brain Tumor?

Cysts and tumors are two different things. The majority of cysts are fluid-filled sacs, although some
might be filled with air or semi-solid material. Tumors, in contrast, are abnormal solid masses of
tissue.
Most cysts found in the brain or elsewhere in the body are benign (non-cancerous). However,
malignant (cancerous) cysts can be produced by many types of cancer. When a doctor is in doubt, a
biopsy is necessary to make a diagnosis.
How Is an Arachnoid Cyst Diagnosed?
Arachnoid cysts are usually identified via magnetic resonance imaging (MRI) or computerized
tomography (CT) scans. Ultrasounds can also reveal arachnoid cysts in a fetus or infant. In most
cases, the scans can distinguish an arachnoid cyst from a tumor or other type of cyst.
Are Arachnoid Cysts Benign or Malignant?
All arachnoid cysts are benign. The sac of an arachnoid cyst is made of arachnoidal tissue and
collagen and filled with cerebrospinal fluid, which flows in the space between the arachnoid
membrane and pia mater, the innermost membrane which covers the brain and spinal cord.
While arachnoid cysts are not cancerous, they can grow larger and cause a range of neurological
complaints and problems. Many arachnoid cysts, however, cause no symptoms at all, and may be
discovered incidentally when a patient is having a scan for other reasons.
What Are the Symptoms of an Arachnoid Cyst?
Arachnoid cysts on the brain can vary in size from very small (several millimeters) to very large,
causing compression or displacement of the brain and producing such symptoms as headaches,
dizziness, tremors, vertigo, hearing or visual disturbances, nausea, vomiting, balance problems,
seizures, ataxia, behavioral or mood changes, memory problems, bladder or bowel issues,
hydrocephalus (too much fluid around the brain), increased intracranial pressure, hyperreflexia or
hyporeflexia, heat intolerance and more. In infants and children, the brain cysts can also cause
developmental delays and cranial deformation.
Spinal arachnoid cysts may cause nerve compression with symptoms such as back or limb pain,
tingling or pins and needle sensations, numbness, muscle weakness, bladder and bowel problems,
and abnormal reflexes.
Treatment of Arachnoid Cysts
Arachnoid cysts do not always require treatment, but they should be monitored for growth.
Medications may be prescribed to address individual symptoms. Patients with complaints of back
aches, headaches or neck pain may find relief with the use of an orthopedic pillow. Reducing
caffeine, avoiding heat and humidity and reducing stress may be helpful in alleviating some other
symptoms.

Arachnoid cysts that are judged to be very problematic are treated with surgery. Until recently the
most common procedure was to insert a shunt into the cyst which allowed the fluid to drain. More
common now, however, is complete fenestration and removal of the cyst using microneurosurgical
and endoscopic advances.
Most patients recover quickly from surgery and experience an immediate and progressive
improvement of symptoms. In some cases, however, complications of surgery or shunts can occur.
Despite the range and severity of problems in patients with arachnoid cysts, many neurologists
dismiss the cysts as asymptomatic and suggest that patients instead are suffering from stress and
experiencing psychosomatic symptoms. Patients may have to visit a number of doctors before
finding one that takes their concerns and problems seriously, or before finding one who is
experienced in treating this rare brain and spinal disorder.
Arachnoid cyst patients and their families can find more information and support through such
organizations as Arachnoid Cyst Support Group and the Arachnoid Cyst Awareness Organization.
Sources:
www.mayoclinic.com; The National Institute of Neurological Disorders and Stroke (NINDS); Seattle
Children's Hospital Research Foundation (www.seattlechildrens.org),
http://suite101.com/arachnoid-cysts-of-the-brain-and-spine-a329138
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