Chronic Arachnoidal Cysts of the Middle Cranial Fossa and Their Relation to Trauma

Supratentorial extracerebral cysts in infants and children.

“…In our cases, as well as in other published series, two main histological types were encountered; simple arachnoid cysts (Starkman et al, 1958) and cysts with more complex walls featuring neuroglia, ependymal lining, and, sometimes, other tissues (Jakubiak et al, 1968). All Sylvian fissure cysts studied have been of the simple arachnoid type (Oliver, 1958;Starkman et al, 1958;Tiberin and Gruszkiewicz, 1961;Robinson, 1964;Gruszkiewicz and Peyser, 1965;Holst, 1965;Weinman, 1965;Wilson and Bertran, 1966;Jakubiak et al, 1968;Pichard, 1968;Bhandari, 1972); so that the Sylvian cyst syndrome seems as well defined histologically as clinically. Cysts of the interhemispheric fissure and of the convexity, on the other hand, have been more variable, many of them containing an ependymal lining and neuroglial remnants (Okonek, 1938, our cases 11 and 12;Jakubiak et al, 1968, cases 1 and 2; Berkmen et al, 1969;Bhandari, 1972).…”

“…Intracranial bleeding has been frequently recorded (Gruszkiewicz and Peyser, 1958;Robinson, 1958Robinson, , 1964Tiberin and Gruszkiewicz, 1961;Pichard, 1968) and is exemplified by our cases 8 and 9. It may be intracystic or subdural, sometimes on the contralateral side (Robinson, 1964), and gives rise to an acute neurological disorder.…”

“…These constitute a heterogeneous group of space-occupying lesions, variously described as benign brain cysts (Handa and Bucy, 1956;Torma and Heiskanen, 1961), cystic hygromas, pseudoporencephalies, or closed porencephalies (Drew and Grant, 1948). More recently, it has become evident that at least part of these cavities belong to a welldefined anatomocinical entity, usually designated as middle cranial fossa or Sylvian fissure arachnoidal cyst (Starkman et al, 1958;Tiberin and Gruszkiewicz, 1961), but otherwise referred to as middle fossa external hydrocephalus or the temporal lobe agenesis syndrome (Robinson, 1955(Robinson, , 1958(Robinson, , 1964. Whatever the differences in opinion concerning the exact location and nature and mechanism of the 'pouches' or cysts, their clinical and radiological presentation is remarkably uniform.…”

“…It may be intracystic or subdural, sometimes on the contralateral side (Robinson, 1964), and gives rise to an acute neurological disorder. Even when no bleeding takes place, some cysts may produce symptomatic intracranial pressure, either in childhood (Okonek, 1938;Dott and Gillingham, 1958;Tiberin and Gruszkiewicz, 1961;Anderson and Landing, 1966;Bhandari, 1972) or much later (Handa and Bucy, 1956;Ghatak and Mushrush, 1971;Bhandari, 1972), or signs of a focal expanding lesion simulating brain tumour, especially in adults. Convulsive seizures may be related partly to the pressure effect of the cysts, as they may subside after operation (Roger et al, 1964;Vigouroux and Choux, 1966;Bhandari, 1972).…”

Prognosis of Four Cases of Primary Middle Fossa Arachnoid Cyst in Children

“…In 2 cases, block of the lateral route and RI retention in the cyst could be seen at a late stage and in case 4, only block of the lateral route was observed. It has been observed by some authors that the cyst communicates with the subarachnoid space in the region of the basal cistern [10,14]. In our cases, RI did not enter at an early stage and in case 4 not even at a late stage.…”