Arachnoid Cyst and Psychosis: The Troublemaker or Innocent Bystander

Abstract

Organic underpinning of a psychotic disturbance is often missed. Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. In most cases, they are diagnosed by accident. Literature regarding the coexistence of arachnoid cysts with psychiatric disorders is sparse. Here, we present a case who presented with a typical presentation of psychosis which was not enough for suspecting for an organic etiology.

Psychosis and iddle cranial fossa arachnoid cyst: Case report and literature review

“…At the time of this writing, this case, reports the smallest middle cranial fossa-arachnoid cyst that produces symptoms without any signs of increasing ICP. Such finding aligns with previously reported cases that have argued for the anatomical association between arachnoid middle cranial lobe cyst with psychosis rather than from increasing ICP (Das et al, 2017;Vakis et al, 2006). Overall, the quality of the patient's life urges the need to use such association in the decision to operate, and the patient or the guardian should have the choice in such decision.…”

“…Besides, in its extreme it can lead to a syndrome of Kluver and Bucy (Kiernan, 2012;Hoesen, 1995). Hence the anatomical association between psychosis and middle cranial fossa lesions, especially arachnoid cyst, is established, but its causation needs to be elucidated (Blackshaw & Bowen 1987;da Silva et al, 2007;Mironov et al, 2014;Bahk et al, 2002;Das et al, 2017;Vakis et al, 2006;Maner et al, 2014).…”

“…Such behavioural changes were not related to to increase ICP. In an elaboration for the cause and effect of the cyst; it was noted that even if the middle cranial fossa-arachnoid cyst produced an increase in the ICP, antipsychotic drugs are also required, despite ICP reduction (Das et al, 2017;Vakis et al, 2006). Hence, the cyst-psychosis association should not be attributed to increased ICP.…”

Anxiety, phobia, and depression in patients with temporal arachnoid cyst–a case report

“…1 In most cases, arachnoid cysts are present at birth (congenital) and may appear to be increasing in size. [1][2][3][4][5] However, patients may live their entire life without any explicit symptoms from the cyst, even if the cyst is large. [3][4][5][6] In the cases which symptoms occurred, their clinical manifestations differ and are often unspecific.…”

Arachnoid Cyst and Psychosis

“…Their known incidence accounts for only 1% of all intracranial space-occupying lesions, and detection is usually incidental. Case reports regarding the coexistence of arachnoid cysts with psychiatric disorders are sparse [ 1 ]. Arachnoid cysts are formed when the arachnoid membrane contains cerebrospinal fluid and are frequently located in the Sylvian fissure [ 2 ], middle cranial fossa, suprasellar area, or posterior fossa.…”