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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Hello Maria and Pat,
Just wanted to give you an update on my situation. I went to a neurologist 2 weeks ago, he reviewed my MRI, asked many questions (unlike the neurosurgeon), did some reflex testing. He was so much more personable and interested in my condition then the neurosurgeon. I advised the neurologist that my symptoms have began to relieve themselves over the past month. The pressure in the back of my head, dizziness and being light headed have gradually subsided, there have been some times still while driving I start to feel the pressure but definitely not as bad as it had been. He was concerned that I would feel that way while driving.
He advised me the neurosurgeon I previously saw is one of the best in Indianapolis that deals w/AC's so if he does not believe surgery is necessary at this time then obviously he has good reason. I let the neurologist know if I don't have to have brain surgery, I would rather not. But just felt left out in the cold and didn't know what to do.
The neurologist does believe my symptoms are due to the cyst. And since the neurosurgeon recommended not to have surgery and the fact my symptoms are subsiding, he decided to place me on a medication to help with my vertigo symptoms as well as my anxiety that I get while driving (driving was when I originally felt all the symptoms). After being on it 2 weeks, I feel wonderful. The pressure is completely gone (even though the pill isn't suppose to do anything for it) the vertigo symptoms have stopped. And I have been able to drive without feeling the symptoms coming on. I honestly do not know if it is all due to the pill since the symptoms were beginning to relieve themselves prior to me taking it. I'm very thankful for this though.
I go back in two weeks for a follow up with the neurologist. I'm happy we have a game plan to help me through this. Of course he did say, if I wanted to have surgery to remove it I could find a doctor to do so, but he doesn't recommend it if the symptoms are going away. He asked if anything happened to me prior to the symptoms coming on, I advised the only thing that I could think of is I flew on a plane for the very first time in my life 1 month before. I did notice the dizzy spells starting soon after but thought, it was an inner ear issue and that was when I started seeing an ENT. So I don't know if the pressure in the cabin from flying caused the cyst to 'wake up'.
I will keep you informed as I go through this process. I truly am thankful for your help and support.
Thanks,
March 28, 2010 - 12:38pmAdrian
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I'm am so glad it has helped you understand. These cysts can put pressure on a number of areas of the brain; all of which have their particular functions. And when one area cannot function correctly, or function at all, it can cause a number of symptoms - both physical and neurological.
I will be interested to know what happens with your husband; when you can get him seen, and what they decide to do. Please keep us updated here at EmpowHer.
Good luck and you and your husband will be in my thoughts and prayers.
February 21, 2010 - 5:13amMaria
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This blog has helped me understand what is happening to my husband better. I am now a member of this site. it looks like its a great site. I am the annonymouse person right above this comment.
February 21, 2010 - 12:07amThis Comment
Our insurance is APIPA Personal Care Plus. I do know they are contracted with 3 neuroseurgeons but i do not think they workwithwhat my husband needs done. Thank you for your support. We are going to wait to see who we get a referal to. I just hope who ever we get sent to is a good doctor and will listen to my husband and help him.i will keep everyone updated. thankyou again for you support.
February 20, 2010 - 11:37pmThis Comment
Hello Anon - I am a Guide for EmpowHer and have been following this discussion. I'm sorry to learn of your husband's situation, but glad that you've found us and have connected with Maria, who is an incredible resource.
I've taken a look at the APIPA plan information in Arizona, for both Medicaid and Medicare, and have also used their online directory to see which hospitals they are contracted with. The directory was a bit hard to work with, but if I did it correctly St. Joseph's and Barrows are not contracted with them. I don't want to alarm you, or add to your burden, but most insurance plans cover surgery and other major procedures only at contracted facilities, so it will be important to know exactly which hospitals APIPA has a contract with as you work with your neurosurgeon and other medical specialists. There are other good hospitals that were listed, including Banner Good Samaritan, which has an extensive Neurosciences program.
Whatever the case, Maria and I will be happy to work with you as you and your husband to through this process and to help you by providing a listening ear, answering questions and, if you need them, finding support resources.
February 20, 2010 - 8:10pmTake good care, Pat
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Our insurance is APIPA. Heis not contracted with them :(. We have been to the er 6 times and they give him pain meds but nothing works. we are waiting for our insurnace to get the referal to a Neurousrgeon. Ill cal monday to see if they have accepted it yet. I found 3 Neurousrgeon that accept our insurance at the barrows institute but i dont know if they do craniotomy. Thank youfor your kind words. Im glad that you got the help that you needed and still continueto wrok witha great Neurousrgeon.
February 20, 2010 - 6:07pmThis Comment
I am so sorry to hear about your husband's situation. It is disturbing to me why and how doctors today can deny a person help and medical treatment. I sympathize with both of you, especially because hearing what you have said reminds me so much of what I went through. I couldn't get anyone to listen to me either and all the doctors, from Internist, Neurologist and even a Neurousrgeon told me that mine shouldn't be causing the symptoms I was having. And my cyst takes up over a third of my brain. It is the largest cyst most doctors I have seen for this, have seen in their practice.
The advice I can give is to keep pursuing help. Set your husband up with every doctor you can..make several appointments and whoever can get him in first, see him (or her). If you need to, take him to the Emergency Room. Once a neurosurgeon sees him in the ER, he becomes his patient. He will then be able to see him out of the hospital and in his office. If you are willing to and can travel, Dr. Robert Spetzler in Phoenix, Arizona at the Barrow's Institute is amazing. He was my surgeon and he understands these types of cysts well. Dr. Allan Friedman at Duke University in NC is also amazing. He is my follow doctor now that I live here in NC, and he understands these cysts well too. He listens, and believes.
I hope that you can get help for your husband. Keep pounding the pavement is the best advice because there are doctors out there that do know these cysts, and know what they are capable of. When one says no, there is someone else that will say "yes" to helping your husband. Be insistent with the doctor, whomever he sees, that this was not how he was before. Keep records of his symptoms - a diary, so that you can record his transition, new symptoms etc. That really helped me.
Good luck and keep me posted!
February 20, 2010 - 12:33pmMaria
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My husband has been diognosed with an arachnois cyst in cerebellum/posterior fossa. The hospital told us it was the size of a golf ball but that it was not causing his migrain that he had cluster heac aches. a few weeks went by and my hudbands constant headach got worse . we went to a nerologist who said he had a contant tension head ach that turnes in to a migrain. Well his head ach never went away he start throwing up all the time cant eat can go to work his vision is blurry now and his tast buds have changed. i took him to the hospital to get another mri and they told us his cyst was now8by3.8by3.5cm. so that means it has grown. we went to our nuorologsy and he told us there was no way this cyst grew taht much in 2 months.( we dont have the original mri) so we are being sent to a neurosurgeon. we have state insurance so who knows how long it will take. no pain meds are working and my husband cant eat anything. how can they not keep him in the hospital to help him? im so worried and confused my husdans needs help any advice is welcome.
February 20, 2010 - 12:07pmThis Comment
That is true Melanie, they may be just as unsure and uncomfortable about the situation as you are frightened. I tried to reach out to the friends of mine who weren't there for me, and even with my reaching, only one came around. I ended up cutting ties with one friend I had been friends with for years because of her lack of support. Not to mention it was upsetting to me that I was getting all these emails about other friends of hers that she wanted me to pray for that were dealing with medical problems, but yet she would never ask how I was, send out notes to others about my situation and ask them to pray for me. It was if I hadn't gone through anything. When I confronted on it over a year later, she had no explaination or reason for not being in touch or asking me how I was or any of her behaviors. We haven't spoken since and that was a few years ago. I just couldn't imagine not being there for a good friend of mine who was going through something as traumatic as brain surgery. But everyone is different and I try to remember that. Maybe some of it is fear. The most we can do is behave how "we" would want to be treated, with our friends and family. The old saying, "Do unto others."
February 17, 2010 - 1:47pmThis Comment
I have had a similar experience. Two friends, that i met through my husband prior to our marriage, didn't call once to see how i was doing, and both knew that i was going in for surgery, and how complex and major of a surgery it was. I have yet to hear from either one of them and the surgery was three weeks ago. I am guessing that as Maria mentioned - fear. Not sure what to expect, have i changed, am i still the same person i was prior to the surgery, are they supposed to be sympathetic to me, should they treat me differently, blah blah blah. Although it is discomforting to have friends that you felt were close, to keep their distance at a time when friends and family mean the most and are the most welcome, I also have to remember that not everyone knows how to handle a situation such as this and i cannot judge them because of this one incident. They are valuable friends in many other ways so we just have to keep an open mind, and an open heart to those that are less fortunate than ourselves and do not have the inner strength to face someone going through an ordeal such as ours.
February 17, 2010 - 9:08amThis Comment