Radiological and Clinical Features of an Arachnoid Cyst of the Quadrigeminal Cistern

Abstract

Cummins, Taveras, and Schlesinger (1960) Case Report A 13-month-old boy was admitted to the Syracuse Memorial Hospital on March 29, 1960, because of regression in neuromuscular function and a rapidly enlarging head. The baby had developed normally to the age of 10 months at which time he could stand with help and spoke a few simple words. He then became irritable, slowly lost the ability to stand or sit, and at 12 months developed an internal squint of the right eye.The mother's pregnancy and delivery were uneventful. There was no history of infectious disease in childhood.Physical examination revealed a very irritable child. The skull was enlarged (52 5 cm. maximum circumference), but the scalp veins were flat and no cranial bruit was heard. Neurological examination demonstrated a right abducens palsy, bilateral papilloedema, a positive MacEwen's sign, and severe generalized spasticity and clonus. The blood count and urine analysis were indeterminate. Plain skull films showed widened sutures, an enlarged vault, and a simple linear fracture in the right parietal bone.On the second hospital day subdural taps were performed through the enlarged anterior fontanelle, but no fluid was obtained.Two days later contrast radiographs were obtained. (A detailed description of the pertinent films made during this and subsequent studies is given beneath Figs. I and 2.)A gas ventriculogram was performed first because of 374

Cerebral arachnoid cysts in children

“…These features were described by Lourie and Berne (1961) and considered diagnostic. They were also noted by Kruyff (1965).…”

Unusual Arachnoid Cyst of the Quadrigeminal Cistern in an Adult Presenting With Apneic Spells and Normal Pressure Hydrocephalus. Case Report.

“…14) The aqueduct and fourth ventricles are displaced downwards and forwards and tectal compression occurs. 14,15,21,23,26,29,33) Generally, the suprapineal recess is elevated and bowed around the cyst, but may extend for a variable distance upward through the tentorial notch, and can be seen on reformatted CT 3) or MR imaging. The posterior part of the third ventricle is invaded and displaced anteriorly, although not observed in our case, and the anterior cerebellar vermis is compressed.…”

“…Other symptoms include Parinaud's syndrome, 9,15,17,19,33) visual disturbances, 4,18,19,21,33,36) nystagmus, 4,12,19,21) hearing deficits, 19) hemiparesis, 33) paraparesis, 23) generalized spasticity, 7,23,25) clonus, diplopia caused by trochlear nerve, 26,27) lateral rectus palsy (due to intracranial hypertension), 23) and precocious puberty. 9) Our patient presented with memory and gait disturbances, and sphincter incontinence of chronic duration, all consistent with NPH, which was considered to be due to aqueduct stenosis.…”

“…Paracollicular arachnoid cyst, 5,21,25) cyst posterior to the third ventricle, 17,21,23) tentorial notch arachnoid cyst, 22) cyst of cisterna ambiens, 22) paramesencephalic cyst, 12) and parapineal cyst 12) are all synonyms for quadrigeminal cistern arachnoid cyst. Sixty cases have been reported including ours, 14,18,30) but only 16 have been adults 2,4,5,13,14,18,19,22,25,27,33,36) (Table 1).…”

Infratentorial arachnoid cysts

“…Since that time, a number of case reports of arachnoid cysts in the posterior fossa have appeared in the literature. 1,2,[4][5][6][7][9][10][11][12][13][14][15][16][17][18][15][16][17][20][21][22] The hypotheses offered to explain the development of these cysts have included congenital malformation, 5'6'19 infection, 3,4 trauma, 4,7,~7,1s,2~ increased intraventricular pressure,2, 2~ and embryonic rests. 22 Arachnoid cysts also have been described in association with tumors in the posterior fossa and are presumably produced by some form of transudate.4.s…”