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.
Arachnoid cysts can grow anywhere on the brain with the primary areas being the side of the brain, and the top of the brain. When a cyst forms on the back of the brain, this is called a posterior fossa arachnoid cyst. A posterior fossa arachnoid cyst can create pressure on the brain stem and the cerebellum. These are extremely vital organs of the brain and they both produce tremendous functions that are required to live.
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.
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I definitely agree. I guess I was saying is that I have had so many physicians, and although my surgeon in Phoenix was not all about making friends, talkative so-to-speak, he was pleasant. You got the sense that not only did he know what he was talking about with my condition, and he was very intelligent, he just kind of stayed his distance emotionally and personally. That did not bother me. On the other hand, the follow-up doctor I saw in Albuquerque most definitely came across as being arrogant, rude, and non-believing in my case. He had extensive training, even flew to China a lot to lecture...he was the chief neurosurgeon there and treated me as if I was some crazy woman. So sometimes credentials, in my opinion, don't always matter. If you do not feel comfortable with the doctor, see someone else. They may have just as impressive of credentials as the doctor before, but also possess better bedside manners and a caring spirit. The doctor who follows me here at Duke, Dr. Allan Friedman, is the chief neurosurgeon. He operated on Senator Kennedy a while back with his brain tumor. He is an amazing man. He never makes me feel like I am being rediculous with my symptoms and my concerns. He treats me like I am a person with a medical condition and spends quality time with me each time. There is a distinct difference in each doctor with their personalities and what one patient may consider good bedside manners, compassion, and understanding, another may think of them as rude and non-helpful. It is an individual's choice and preference as to what type of physician (or personality of a physician) that you choose and get a long with. I do think a lot of doctors lose their humanity. I think a lot of doctors start to view their career as just that, a career, rather than a field of helping others and the need for them to be compassionate and understanding. It's a fine line.
March 9, 2010 - 3:01amThis Comment
I agree....I think that all up and coming physicians should have to either get sick themselves and need medical attention, or watch the movie (which the name slips my mind now) where the arrogant doctor got really sick and learned first hand what it was like to have compassion and it taught him humility.
Doctors, many of them but not all, lose a lot of humanity I think. They look at patients many times as a "bother" or hypochondriacs. Many things that we are not. Second, third, and fourth opinions should be sought after if you do not feel comfortable with a doctor. I couldn't agree with you more!
March 8, 2010 - 6:32pmThis Comment
Maria, while I agree that it's important to feel comfortable with a doctor, I think it's just as critical to check the physician's credentials and training. I personally know some excellent neurosurgeons some people might consider "abrupt" who are individuals I would trust with my own brain literally in their hands. I also know some very nice, charming individuals who are incompetent. The best route for all of us is to be our own best advocate and find the physicians who have the best skills and are committed to partnering with us to ensure we get the best care possible. Do you agree? Pat
March 8, 2010 - 6:45pmThis Comment
Hi all -
I have been reading the latest posts. I am appalled (sp) to know that there are even surgeons out there that would treat people this way! I feel lucky in knowing that i had two awesome surgeons perform my surgery. If i were in any of their shoes, (patients) and were concerned about my health or the health of my spouse, i would most defenitely get a second opinion if i were treated that way and you can bet your bottom dollar that i would contact whatever board i needed to and file a complaint against that doctor!!!!. When we are facing something that is as risky and as "life changing" as brain surgery of ANY kind, quite possibly the MOST important thing we are seeking and needing is support, kindness, understanding, knowledge and the reassurance to know that we are in good hands. My prayers go out to you Missy Anne- seek a second opinion for your husband - you WILL find a surgeon that will listen to you, understand how you feel and will treat you like a human being with the respect that you deserve - they are out there!!!!!!!!
March 8, 2010 - 6:30amGod Bless you and God Speed.
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Hi Melanie - Thanks for writing and offering your support to others. How is your own recovery from your surgery going? Is there anything you've learned now that you wish you had known before, things that might be helpful to others in the future when they read this thread? Hope all is going well for you. All the best, Pat
March 8, 2010 - 5:28pmThis Comment
Pat
March 5, 2010 - 12:35pmThank u for the other web-site it was good to read more information in this area. I sill in my resreach have not been able to find out if any of the nero surg in my area have experience with these kinds of cyst. Was able to call my sons pediat and get a copy of the visits to the nuro surg where she said she was going to drain guess I will call Arnold palmer and hope that their ped nero surg know about these cyst if that doesnt work will have to go to shrinner in gainsville. Thank u for your help and knowleger in this area will keep u up dated
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Hi Anon - I took a look at St. Joseph's Children's Hospital in Tampa, and they do have pediatric neurosurgeons on their staff. If you go to the physician search page on their website and do a search in the specialty category for "neurological surgery" you will be able to pull up information on all of the neurosurgeons with privileges at the hospital. http://www.sjbhealth.org/body_childrens.cfm?id=1274
You can follow a similar process at the other hospitals in your area to locate the pediatric neurosurgeons.
It will be important to know that the surgeon, and the hospital, are covered by your health plan. Since there are several different Blue Cross Blue Shield plans in Florida be sure to enter the exact plan when doing these searches. You may also want to go to your plan's website and search there as well.
When you have identified the pediatric neurosurgeons/hospitals that are on your plan you can then contact their offices (or view their website if they have one) to find out if they have experience with these cysts. It will be important to verify that they do accept your insurance plan. Even if a website says they do you will find that this changes and websites sometimes aren't updated so be sure to check this. The closer you can get to home the better so I hope you will be able to find a great doctor and hospital near your home.
You might also want to ask your son's pediatrician for a recommendation too and for the pediatrician's view of the various hospitals in your area and which one would be best suited for the specialized care your son needs.
I know this is a lot of research and time for you, but I hope it will help you stay positive to remember that you're working to find the very best care you can for your child. Please do stay in touch, and let us know how we can help support you.
March 5, 2010 - 6:02pmTake care, Pat
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I wasnted to update everyone on my husband. we went to the NS and he told us that my husbands problems where not fromhis cyst. I asked if it had grown and he just kinds ignored me so im assuminghe didnt even looka t the 2 mris. He told my ubby you circled 18 out of 21 posible symptomes there is no way that this is your problem. he asked us what we wanted and we said to get the cycs taken care of that he is helthy besides the cyst and its symptoems. He told us taht most people dont jump to have brain surgery and that we where posibly going to disable or kill him with this process. he refused to help us and said are we donehere or what. what ann a$$! We are going to try and get a second opinion. My husband and i both where happy to know the cyst might have not grown but the surgeon never answered us so we dont know. My hubby is looking for a new NS and a pain managment dr becuase he it so sick and hurting so much no one will give him pain meds thinking he is drug seeking. its very upsetting to me. His disability seems lioke it will be denied we find out on march 1th what they say. I am going to be looking for a job. my hubby cant work and now he is going to have to watch my 3 and 1 yr old while i work because we have no money. i feel stuck. and my poor husband. im sorry everyone has to be in pain.. i wish i could make it all stop .
March 5, 2010 - 10:32amThis Comment
Hi Missy Anne - I'm so sorry you and your husband had such a bad experience with the first neurosurgeon. I hope you can put that experience behind you and continue to advocate for your husband and get a second opinion. Since your husband's case is complex you may be able to get the services of a nurse case manager to help you with some of the challenges you're facing. It may be worth a phone call to find out.
As far as the disability application, from what I hear most applications are denied the first time through, and some are denied several times, and that too may take a lot of persistence and having to advocate for your husband. I don't mean to discourage you, I'm just trying to provide information to help prepare you for the situation based on the experiences that others have had.
If my memory is right you are in the Phoenix area. I suggest looking at the Southwest Job Network, a nonprofit organization which provides many services for job seekers free or at minimal cost. It's a warm, supportive group of people. http://www.southwestjobnet.com/
I know you are both having a rough time right now and it's hard. I hope you will find a way to gather the strength needed to not only help your husband but to also help yourself in making it through this situation and getting the assistance you need. Please let us know how we can help. We wish all the best for both of you.
March 5, 2010 - 5:33pmTake care, Pat
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hi my 13yr old son has a posterior Fossa Arachnoid Cyst. I have the mri reports and none of them say what the size of it is just listed as large. In the last 3 months we have been to nerologist and nero surg. btw he also has posibly marfans synd. The nerg surg said on first visit that it would have to be drain ( in hosp or with shunt) on last visit she seemed to do 180 now wants to do nothing. the nerologist said that it would have to be drain do to location is it common to have this back and forth. I worry that if they do nothing he could have worse problems. I live in Fl and would love to hear about some really good dr that know what they are doing down here. He has had many of the common symptoms. My worry is the he will start having the seiures that i know can cause long term nerologic problems and he trys to have such a normal life when he is symptom free and is very active. Any advice or suggestion in how to get him the best treatment would be appreciated.
March 3, 2010 - 9:58pmThis Comment