Monozygotic Twins With Mirror Image Cysts: Indication of a Genetic Mechanism in Arachnoid Cysts?

Helland, Christian A.; Wester, Knut

doi:10.1212/01.wnl.0000265060.93709.00

Cited by 22 publications

(15 citation statements)

References 5 publications

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“…However, only small case series on mirror images involving the brain have been reported8,9,10. To our knowledge, only one case of mirror-imaging of arachnoid cysts (AC) has been reported11, which is different from our case in some respects. We report a case of a pair of MZ with mirror-imaging of AC in the temporal fossas and discuss the possible clinical implications.…”

Section: Introductioncontrasting

confidence: 98%

“…First, Helland and Wester11 reported a pair of 12-year-old MZ with mirror-imaging of AC in the cerebellopontine angle and indicated that genetic factors were important in the predisposition to cystogenesis in some patients. Previously, both the familial occurrence of AC and the presence of AC in patients with genetically determined cystic diseases, such as ADPKD, have indicated a genetic component in the cystogenesis of AC18.…”

Section: Discussionmentioning

confidence: 99%

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Mirror-Image Arachnoid Cysts in a Pair of Monozygotic Twins: A Case Report and Review of the Literature

Zhou

Pu²,

Chen³

et al. 2011

Int. J. Med. Sci.

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Mirror-imaging of arachnoid cysts (ACs) in monozygotic twins (MZ) is extremely rare. We describe a pair of MZ who developed mirror-imaging of ACs in the temporal fossas, and we also review the literature. Brain computer tomography (CT) and Magnetic Resonance Imaging (MRI) of the MZ revealed mirror-imaging of vast lesions of cerebrospinal fluid intensity in their temporal fossas. This is the second ever report of such a case according to the available literature. Unlike the prior case, our patients were 14 months, which is a much younger age than the patients of the previous report. Consequently, our case is better in supporting a genetic origin in the pathogenesis of AC. The findings in our case indicate that early neuroimaging is mandatory in the counterpart of the symptomatic patient with AC, irrespective of the absence of symptoms.

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Section: Introductioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Mirror-Image Arachnoid Cysts in a Pair of Monozygotic Twins: A Case Report and Review of the Literature

Zhou

Pu²,

Chen³

et al. 2011

Int. J. Med. Sci.

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“…Some of these patients have been presented in previous publications from our department, 29, [34][35][36][37][38]40,63,[81][82][83][84][85][86][87] including 1 article addressing the same questions as this study, but using a much smaller patient sample. 83 The patients were identified from the hospital's computer data bank of diagnosis and treatment, with registration of every patient in the period with the diagnostic codes 348.0 (ICD 9) or G93.0 (ICD 10), the codes assigned to patients with arachnoid cysts in our hospital during the study period.…”

Section: Study Design and Data Extractionmentioning

confidence: 99%

Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample

Helland

Lund‐Johansen²,

Wester³

2010

JNS

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Arachnoid cysts have a strong predilection for the temporal fossa. There is a sex dependency for some intracranial locations of arachnoid cysts, with temporal cysts occurring more frequently in men, and CPA cysts found more frequently in women. Furthermore, there is a strong location-related sidedness for arachnoid cysts, independent of patient sex. These findings and reports from the literature suggest a possible genetic component in the development of some arachnoid cysts.

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“…They can be found all along the cranio-spinal axis, but have a marked predisposition for the temporal fossa [4]. The mechanisms underlying the formation and filling of arachnoid cysts are not well understood, but clinical, epidemiological, and laboratory data indicate that genetic mechanisms are involved in the formation of arachnoid cysts [5,6]. Three prevailing theories exist for the filling of the cyst: 1) active secretion of fluid by cells in the cyst wall [7,8], 2) fluid influx due to an oncotic pressure gradient [9], and 3) trapping of fluid by a valve mechanism [10].…”

Section: Introductionmentioning

confidence: 99%

Arachnoid cysts do not contain cerebrospinal fluid: A comparative chemical analysis of arachnoid cyst fluid and cerebrospinal fluid in adults

Berle

Wester

Ulvik

et al. 2010

Fluids Barriers CNS

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BackgroundArachnoid cyst (AC) fluid has not previously been compared with cerebrospinal fluid (CSF) from the same patient. ACs are commonly referred to as containing "CSF-like fluid". The objective of this study was to characterize AC fluid by clinical chemistry and to compare AC fluid to CSF drawn from the same patient. Such comparative analysis can shed further light on the mechanisms for filling and sustaining of ACs.MethodsCyst fluid from 15 adult patients with unilateral temporal AC (9 female, 6 male, age 22-77y) was compared with CSF from the same patients by clinical chemical analysis.ResultsAC fluid and CSF had the same osmolarity. There were no significant differences in the concentrations of sodium, potassium, chloride, calcium, magnesium or glucose. We found significant elevated concentration of phosphate in AC fluid (0.39 versus 0.35 mmol/L in CSF; p = 0.02), and significantly reduced concentrations of total protein (0.30 versus 0.41 g/L; p = 0.004), of ferritin (7.8 versus 25.5 ug/L; p = 0.001) and of lactate dehydrogenase (17.9 versus 35.6 U/L; p = 0.002) in AC fluid relative to CSF.ConclusionsAC fluid is not identical to CSF. The differential composition of AC fluid relative to CSF supports secretion or active transport as the mechanism underlying cyst filling. Oncotic pressure gradients or slit-valves as mechanisms for generating fluid in temporal ACs are not supported by these results.

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Monozygotic Twins With Mirror Image Cysts: Indication of a Genetic Mechanism in Arachnoid Cysts?

Cited by 22 publications

References 5 publications

Mirror-Image Arachnoid Cysts in a Pair of Monozygotic Twins: A Case Report and Review of the Literature

Mirror-Image Arachnoid Cysts in a Pair of Monozygotic Twins: A Case Report and Review of the Literature

Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample

Arachnoid cysts do not contain cerebrospinal fluid: A comparative chemical analysis of arachnoid cyst fluid and cerebrospinal fluid in adults

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