Recurrent arachnoid cyst of Meckel's cave mimicking a brain stem ischaemia. Report of a rare case.

Abstract

UNLABELLED:

A 44-years old man developed TIA-like symptoms with dysaesthesia around the mouth, vertigo and diplopia. MRI revealed a cystic space-occupying lesion on the right Meckel's cave, which spread out into cerebellopontine angle in a further examination. Therefore surgical exploration was performed using a suboccipital approach. An arachnoidal cyst was found and removed including its wall. About three months later the patient suffered again from dysaesthesias of the right side of the face and a new MRI revealed a recurrence of the lesion, with extension into the cerebellopontine angle, too. Surgical revision was done using the same approach and the recurrent cyst was removed. Postoperatively, there were a transient hypaesthesia in the distribution area of the right trigeminal nerve and a light pulmonary embolism occurred as a complication. No symptoms have returned during an observation period of 15 months.

CONCLUSION:

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.

• Authors: B A Wörner, M Noll, T Rahim, U Fink, R Oeckler
• Journal: Zentralblatt fur Neurochirurgie (Zentralbl Neurochir) Vol. 64 Issue 2 Pg. 76-9 ( 2003) ISSN: 0044-4251 [Print] Germany
• PMID: 12838476 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Arachnoid Cysts (diagnosis, pathology, surgery)
• Brain Ischemia (diagnosis, pathology, surgery)
• Brain Stem (blood supply, physiopathology)
• Cerebellopontine Angle (blood supply, pathology)
• Cerebrovascular Circulation (physiology)
• Diagnosis, Differential
• Humans
• Magnetic Resonance Imaging
• Male
• Nerve Compression Syndromes (diagnosis, pathology)
• Nerve Fibers (physiology)
• Neurosurgical Procedures
• Paresthesia (etiology)
• Postoperative Complications (physiopathology, psychology)
• Recurrence
• Trigeminal Nerve Diseases (diagnosis, etiology, pathology)