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I am a 60 year-old woman with an arachnoid cyst involving

inferior right cerebellopontine-cerroebellomedullary angle. Anterior...
I am a 60 year-old woman with an arachnoid cyst involving inferior right cerebellopontine-cerroebellomedullary angle. Anterior bowing of cranial nerve VII-VIII complex as well s mild displacement of soft tissue component. I had a concussion at age five, which resulted in my waking up blind, but regaining vision. I have loss of hearing in my right ear. Is this cyst anything I need to worry about?
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Answered in 13 minutes by:
10/20/2017
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,647
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I see you have questions and concerns related with the arachnoid cyst that you have mentioned above. As a neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

First I need to ask few questions so that I can gather more information related to your health concerns and I will follow up with you and post my questions here ASAP. I am typing the questions now and I will follow up with you as soon as I am ready with my questions.

Best Regards!

Dr Subbanna MD

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Customer reply replied 1 month ago
Thank you for your time...

You are very welcome! I will follow up with you very soon.

Best Regards!

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Kindly answer to these questions, this will help me in gathering additional information related to your health concerns;

1) When was the arachnoid cyst got diagnosed, is it a recent diagnosis?

2) Have you been seen by a neurologist or neurosurgeon after this diagnosis?

3) Approximately for how long are you having loss of hearing on the right side, is it stable now or is it progressive and worsening?

4) Are there any other symptoms such as headaches, facial numbness or facial droop on the right side, or any difficulties with eye movement or double vision, or any weakness of the arms or legs, or vertigo (spinning sensation), ringing sound in the right ear?

Kindly reply

Best Regards!

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Customer reply replied 1 month ago
1. Diagnosed - MRI - 2016 and again 2917, but different radiologist did not do comparison with previous MRI.
2. Neurologist via phone call in in 2016 recommended follow-up MRI to see if any changes.
3. Hearing Loss - present for approximately 10 years, but presently seems more pronounced. Going for audiology/hearing appt tomorrow.Again, many thanks for your time.

You are very welcome! I appreciate for all these additional information. I see you have not replied to another question above (#4), Is it because you are not having any of those additional symptoms, or was it just missed?

Kindly reply

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Customer reply replied 1 month ago
My apologies. With regards ***** ***** 4 - I don’t hace any other symptoms you have listed, except for occasional headaches, which have not been any more intense or more frequent than in the past.

It is fine, please no need to apologize. Once again I appreciate for all these additional information. I am preparing & typing my answer now and I will post my answer here as soon as it is ready. Typing may take few minutes and I will follow up with you and post my answer here the moment I finish with the typing.

Best Regards!

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Okay I am ready; I am posting my answer here;

First I will discuss about this cyst, and after the management and treatment aspects of this type of cyst in the brain.

Cysts are fluid filled cavities or sacs. Arachnoid is the term used for arachnoid membrane which is a layer of protective structure covering around the brain. The cysts are called as arachnoid cyst because these cysts arise from the arachnoid membrane. Arachnoid cysts contain CSF (Cerebrospinal fluid) inside them. CSF is a fluid found in the brain and spinal cord regions.

Arachnoid cysts are considered as congenital or developmental cysts in the brain (people are most often born with these cysts). These cysts are not related to any tumor etc, so nothing to worry from that point of view. Also good news is, most of the time they do not grow or increase in size, rather remain the same size throughout the life.

As you may already know there is no medication treatments for these cysts, and if any treatment is tried then it is surgical like putting a shunt into the cyst and draining the cyst, or excising/removing the cyst etc.

Generally the arachnoid cysts are not treated surgically as they do not cause any symptoms in the patient, and also on most occasions they remain at the same size lifelong. Moreover any brain surgery including an arachnoid cyst surgery carries some risk (bleedings, infections etc) and this is another reason why surgery for the arachnoid cyst is considered as a last resort treatment, and undertaken only when it has to be done and no other option exists.

However if the cyst is growing in size, and clinically if you are developing new symptoms or if your existing symptoms such as hearing difficulty is progressing or worsening then surgical intervention may be required. The new symptoms or manifestations that you need to watch out for include the following;

Progressive weakness of the limbs (especially on the opposite side of this cyst, means weakness of the arms or legs on the left side of your body)

Right sided facial numbness or loss of sensation, or facial droop – as you see – to observe for these symptoms on the same side as the cyst (right side itself)

Severe and/or progressively worsening headaches without any other explanation

Vomiting

Vertigo (spinning sensation)

Double vision

Ringing sound in the right ear etc

If during the follow up brain scan the cyst is found to be growing in size significantly and/or if the patient is considerably suffering from the cyst (in the form of various symptoms that are mentioned above) then surgical intervention is required. I see in your case the MRI scans could not be compared, for the reason you have mentioned above, but we need to try to do this, I have discussed this point below again

I see you have not seen a neurologist so far, there was just a consultation over the phone, but seeing a neurologist is important now, so please try to see a neurologist in the clinic asap, who will perform a thorough clinical evaluation including neurological examination. And the neurologist also need to try to get your old MRI films as well so that they can be compared with the recent one - to check for any interval changes. After that a decision will be made to refer you to a neurosurgeon too for making a decision on whether to just wait & watch now, or to consider surgical intervention to excise or drain the cyst etc.

Once again I reassure you, arachnoid cysts are benign cysts (not associated with tumors etc) and also are not surgically removed on a routine basis, and such surgery is performed only if the symptoms are severe, and also the symptoms can be definitely correlated with the cyst, and also symptoms are progressively worsening etc. Please try to see a neurologist in the clinic so that you will receive a thorough neurological examination in the clinic followed by checking & comparing the MRI scans, and then a final decision will be made regarding the best course of treatment plan, as mentioned above, to benefit you the maximum.

Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,647
Experience: American Board Certified Neurologist, Internal Medicine
Verified
Dr Subbanna MD and 87 other Neurology Specialists are ready to help you
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Customer reply replied 1 month ago
Thank you!

You are very welcome! My pleasure!

Wishing you all the very best!

Thanks & Best Regards!

Dr Subbanna MD

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Dr Subbanna MD
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,647
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