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Need Help or Answers re:Posterior Fossa Arachnoid Cyst

By January 8, 2010 - 1:18pm
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In early October of 2009, my 19 yr old son was complaining that he was having very bad headaches, so bad that he could not gt out of bed and didn't want to lights on in his room. I took him to his PCP and he suggested a CAT scan of the head and the result were normal. He prescribed sinus meds just in case he was having sinus problems. The headaches were almost gone, until December when they came back, again took him to the PCP and this time he ordered a MRI which showed an arachniod cyst in the posterior fossa of the brain. The PCP suggested that we leave it alone and for my son to take 600 ml of Motrin everytime he gets a headache. My question is should we do what was suggested by the dr.or will he need surgery or will if go away on it's own? I am very worried, this child has been through so much, he also has chronic ITP since the age of 11 yrs old and recently had a splenectomy.

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I would strongly suggest getting a second and even third opinion. Ask your PCP to refer you to a neurosurgeon who is well versed in this area. If my tooth hurts I see my dentist ... brain hurts beyond normal stress headache ... I see a neuro :) The neuro can tell you whether or not surgery is optimal at this time and should set up a schedule for yearly MRI's to check for growth of the cyst ... I don't know much about arachniod cysts .... but I do know that at 19 he is still growing and MRI's(MRI with and without contrast and CINE MRI's) are the best method currently to monitor the brain ... Considering that the doctor prescribed Motrin for his headache... that tells me that the Dr feels there is a problem with inflamation as well as pain ... a good question to ask is how much swelling and does this affect his CSF flow? Is this cyst the only brain abnormality? My malformation was NOT found by my doctor... I had to get the radiologist report and read it for myself to discover I had Chiari Malformation... I underwent a posterior fossa decompression and C1-2 laminectomy on May 27, 09 ... education empowHers (shamless plug!) us. Gather as much information as you can ... and get second opinions. The headache is a symptom ... no one wants to go through life wondering if tomorrow will be a day in bed or a day I can go to work :)
God bless ...

January 10, 2010 - 12:10pm
(reply to tharilyn)

Thank you for your insite, my son's hymotologist suggested that I take him to a neurologist so that he can evaluate and monitor my son's cyst, because like you said the PCP is not a brain or head specialist. I made an appointment, taking him today. He also had a MRI last Tuesday. You made a good point about the Motrin, the only problem is that he is not able to take any aspirin products due to his ITP (blood disorder that attacks the platelets) So he has only taken Tylenol, which sometimes work for him. Did the surgery work for you and how are you feeling now? Again, thanks so much for replying to my question. I will keep you posted.
God Bless...

January 12, 2010 - 9:03am
HERWriter Guide

Dear Grace

Thank you for your post and welcome to Empowher!

I'm so sorry that your boy has gone through so much - and as a Mom, it must also be very difficult for you. I hope you both are getting plenty of support from family and friends.

One of our HerWriters, Maria Richmond, has written about this condition. She explains that "an arachnoid cyst is a fluid filled sac that develops primarily in the uterus during the development of the brain and skull. The arachnoid membrane of the brain splits, and the split space fills with fluid known as cerebral spinal fluid. The fluid will enter the split area, but it cannot escape at the same rate as it enters. Because of this, the cyst will grow over time. The growth rate depends on many factors, but even as it grows, more times than not, the cyst will remain asymptomatic. This means that generally, an arachnoid cyst will not cause any symptoms. "

She goes on to say that The brain stem controls a lot of our everyday functions that we do not even think about. One thing it controls is our body temperature. It controls our diaphragm for breathing, and it is where our hunger and thirst are controlled. It is also the path in which all our nerves leave the brain and travel throughout the body. The brain stem controls our pain, it is also where the nausea center is based, and it plays a role in the regulation of our hearts.

The cerebellum; on the other hand, helps control our balance. It plays a role in the reflex of our muscles, and plays a major role in our motor skills. Both parts of the brain have their very specific tasks, and when either one is compromised, it can reek havoc on the entire body.

If treatment is needed for an arachnoid cyst, usually the first choice is a fenestration of the cyst. This means going into the brain with a wand and opening up any walls that may have formed inside the cyst. These walls trap the fluid inside the cyst. The idea of this procedure is to get all the cerebral spinal fluid flowing in and out of the cyst efficiently so that the cyst does not continue to grow. If this procedure does not work, a neurosurgeon may decide to put a shunt in. A shunt helps to keep the cyst draining and not allow fluid to build up inside. If the cyst is small enough and in a space on the brain that is not too dangerous to remove, the neurosurgeon may be able to remove it altogether.

Symptoms can show themselves in many ways; from balance problems, nausea, vomiting, headaches, even seizures. Many cysts are discovered on accident when having a scan for another reason. They can be seen on Cat Scan, but the preferred diagnostic test for a brain cyst, is an MRI.


After this article, you can read comments by some people who have gone through the same thing - some opting for surgery.

We cannot let you know if surgery is right for your son. It will depend on a host of factors from his overall health (he has had previous health problems so this will be taken into account), his age, risks and possible complications and other issues. His doctors can explain his options to him.

Many do chose "watchful waiting" which is monitoring the situation but not doing anything unless medically necessary. Other do chose the surgery but they all have their own reasons.

Does your son seem to be leaning in one particular direction - either watchful waiting or surgery?

January 8, 2010 - 2:39pm
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