Active spontaneous decompression of a suprasellar-prepontine arachnoid cyst detected with routine magnetic resonance imaging

Arachnoid cysts are congenital CSF collections that arise adjacent to arachnoid cisterns. These lesions can be incidental neuroimaging findings but may also cause symptoms and necessitate treatment, particularly in children. The authors present their experience with a male infant harboring a large suprasellar-prepontine arachnoid cyst who underwent spontaneous decompression into the ventricular system, as evidenced by a visualized CSF flow jet observed on routine MR imaging.

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Arachnoid cysts on magnetic resonance imaging: just an incidental finding?

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000808 ◽

2020 ◽

Vol 134 (5) ◽

pp. 424-430 ◽

Cited By ~ 1

Author(s):

L Li ◽

F Begbie ◽

N Grimmond ◽

G Kontorinis

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Clinical Significance ◽

Arachnoid Cyst ◽

Incidental Finding ◽

Arachnoid Cysts ◽

Resonance Imaging ◽

Age And Gender ◽

And Gender ◽

Repeat Imaging

AbstractObjectiveTo determine the clinical significance of arachnoid cysts.MethodsThe scans of 6978 patients undergoing magnetic resonance imaging of the internal acoustic meatus for unilateral cochleovestibular symptoms were retrospectively reviewed. We identified the scans with arachnoid cysts, and assessed the statistical associations between the laterality, location and size of the arachnoid cyst, the laterality of symptoms, the patients’ age and gender.ResultsIn a total of 37 arachnoid cysts identified in 36 patients (0.5 per cent), no associations were identified between the laterality of symptoms and the laterality of the arachnoid cyst, regardless of its size or location. There were no significant associations between the location of the arachnoid cyst and the age (p = 0.99) or gender of the patient (p = 0.13), or size (p = 0.656) or side of the cyst (p = 0.61). None of the cysts with repeat imaging scans (17 cysts) demonstrated growth.ConclusionOur results suggest that most, if not all, arachnoid cysts are of no clinical significance. Given their indolent behaviour, even serial imaging is not essential.

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INTRASELLAR ARACHNOID CYSTS

Neurosurgery ◽

10.1227/01.neu.0000290896.69825.40 ◽

2007 ◽

Vol 61 (3) ◽

pp. 505-513 ◽

Cited By ~ 32

Author(s):

Annie S. Dubuisson ◽

Achille Stevenaert ◽

Didier H. Martin ◽

Pierre P. Flandroy

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Arachnoid Cyst ◽

Water Soluble ◽

Arachnoid Cysts ◽

Resonance Imaging ◽

Rapid Weight Gain ◽

Presenting Symptoms ◽

Subarachnoid Spaces ◽

Suprasellar Extension

Abstract OBJECTIVE To evaluate the clinical, endocrinological, and radiological presentation of nine cases of surgically verified intrasellar arachnoid cysts and to discuss the physiopathological mechanisms of formation of these cysts. METHODS Among 1540 patients presenting with pituitary lesions, nine presented with an intrasellar arachnoid cyst. Their charts were retrospectively reviewed. RESULTS Presenting symptoms included headache (n = 2), visual symptoms (n = 3), menstrual irregularities (n = 2), rapid weight gain (n = 1), vertigo (n = 1), and/or confusion (n = 1). Two cysts were discovered incidentally. T1-weighted magnetic resonance imaging scans showed an intrasellar cystic lesion in all cases, with a huge suprasellar extension in six cases. The cyst was of the same intensity as the cerebrospinal fluid (CSF) in only two patients. A transsphenoidal approach allowed the transdural aspiration of fluid and injection of a water-soluble contrast agent under mild pressure. In three patients, the contrast infiltrated along the pituitary stalk toward the subarachnoid spaces; in the other patients, it remained in the intrasellar compartment. Cyst membranes were removed as completely as possible with fenestration toward the subarachnoid spaces in communicating cysts. In spite of tight packing of the sella and sphenoid sinus, CSF fistulae requiring reoperation developed in two patients. CONCLUSION The clinical picture of an intrasellar arachnoid cyst resembles that of a nonfunctional pituitary adenoma. Magnetic resonance imaging scans typically show a cystic intrasellar lesion with suprasellar extension, containing isointense or, more often, hyperintense fluid on T1-weighted sequences. In spite of the risk of CSF fistulae, the preferred surgical approach is transsphenoidal. A physiopathological mechanism is proposed according to anatomic variations of the sellar diaphragma allowing penetration of subarachnoid spaces into the sellar compartment and their enlargement by a ball-valve mechanism.

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Analysis of magnetic resonance imaging–based blood and cerebrospinal fluid flow measurements in patients with Chiari I malformation: a system approach

Neurosurgical FOCUS ◽

10.3171/foc.2001.11.1.7 ◽

2001 ◽

Vol 11 (1) ◽

pp. 1-10 ◽

Cited By ~ 22

Author(s):

Noam Alperin ◽

Kirti Kulkarni ◽

Ben Roitberg ◽

Francis Loth ◽

Naren K. Pandian ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Mr Imaging ◽

Cardiac Cycle ◽

Chiari I Malformation ◽

Intracranial Volume ◽

Resonance Imaging ◽

Csf Flow ◽

Chiari I ◽

Systolic Phase

Object A pilot study was performed to assess noninvasively the change in intracranial compliance (ICC) and intracranial pressure (ICP) in patients with Chiari I malformation who undergo foramen magnum decompression. The working hypothesis was that the main effect of the decompressive surgery is a change in ICP. Noninvasive cine phase-contrast magnetic resonance (MR) imaging is a motion-sensitive dynamic MR imaging technique that allows for visualization and quantitation of tissue motion and flow. The authors' group has used dynamic phase-contrast MR imaging to visualize and quantify pulsatile blood and cerebrospinal fluid (CSF) flow in the craniospinal system. Methods A system approach has been used to characterize the hemodynamic–hydrodynamic coupling in the craniospinal system and to derive measures for ICC and ICP. Magnetic resonance imaging–based ICC and ICP values are derived from the ratio of the volume and pressure changes that occur naturally during each cardiac cycle. The authors conducted a prospective study of four patients, three of whom were studied before and after decompressive surgery; significant change in MR imaging–derived ICC and ICP values was documented in only one of the three surgically treated patients. A significant change in the dynamics of the intracranial volume change (ICVC) during the cardiac cycle, however, was observed in all three patients. In healthy individuals the ICVC waveform usually consists of the following sequence: monotonic increase in intracranial volume (ICV) during the systolic phase due to increased blood inflow, monotonic decrease in ICV caused by the onset of CSF outflow into the spinal canal, and increase in the venous outflow. A nonmonotonic decline in the ICVC waveform has been observed in all patients with headaches, and a relatively normal waveform was found in those without headaches or whose headaches were resolved or alleviated by the surgery. A “partial-valve” mechanism is proposed as an explanation for the abnormal ICVC dynamics. The monotonic decline in ICVC is interrupted by a “premature” reduction in the CSF outflow. This may be caused by a displacement of the hindbrain into the cervical spinal canal during the systolic phase. This obstructs the CSF flow at the later part of the systolic phase such that the ICV does not continue its gradual decline. Postsurgery, the ICVC waveforms presented a more normal-appearing ICVC dynamics profile. Conclusions Magnetic resonance imaging measurement of transcranial CSF and blood flow may lead to a better understanding of the pathophysiology of Chiari malformations and may prove to be an important diagnostic tool for guiding for the treatment of patients with Chiari I malformation.

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Magnetic Resonance Imaging of an Epidural Spinal Arachnoid Cyst

Acta Radiologica ◽

10.1177/028418518903000509 ◽

1989 ◽

Vol 30 (5) ◽

pp. 491-493 ◽

Cited By ~ 6

Author(s):

J. K. Hald ◽

S. J. Bakke ◽

P. H. Nakstad ◽

I. O. Skalpe ◽

J. Wiberg

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Mr Imaging ◽

Arachnoid Cyst ◽

Cord Compression ◽

Imaging Findings ◽

Resonance Imaging ◽

Cyst Size ◽

Spinal Arachnoid Cyst

The myelography, CT and MR imaging findings in a patient with an epidural spinal arachnoid cyst are discussed. MR imaging excellently demonstrated cyst size, cyst location and cord compression, and should be the method of choice in these cases.

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A Gadolinium(III) Complex Based on the Thymine Nucleobase with Properties Suitable for Magnetic Resonance Imaging

International Journal of Molecular Sciences ◽

10.3390/ijms22094586 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4586

Author(s):

Marta Orts-Arroyo ◽

Amadeo Ten-Esteve ◽

Sonia Ginés-Cárdenas ◽

Isabel Castro ◽

Luis Martí-Bonmatí ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Mr Imaging ◽

Lesion Detection ◽

Resonance Imaging ◽

X Ray Diffraction ◽

Functional Images ◽

High Relaxivity ◽

Contrast Enhanced ◽

Phantom Studies

The paramagnetic gadolinium(III) ion is used as contrast agent in magnetic resonance (MR) imaging to improve the lesion detection and characterization. It generates a signal by changing the relaxivity of protons from associated water molecules and creates a clearer physical distinction between the molecule and the surrounding tissues. New gadolinium-based contrast agents displaying larger relaxivity values and specifically targeted might provide higher resolution and better functional images. We have synthesized the gadolinium(III) complex of formula [Gd(thy)2(H2O)6](ClO4)3·2H2O (1) [thy = 5-methyl-1H-pyrimidine-2,4-dione or thymine], which is the first reported compound based on gadolinium and thymine nucleobase. 1 has been characterized through UV-vis, IR, SEM-EDAX, and single-crystal X-ray diffraction techniques, and its magnetic and relaxometric properties have been investigated by means of SQUID magnetometer and MR imaging phantom studies, respectively. On the basis of its high relaxivity values, this gadolinium(III) complex can be considered a suitable candidate for contrast-enhanced magnetic resonance imaging.

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Assessment of Cerebrospinal Fluid Hydrodynamics Using Magnetic Resonance Imaging in Postcraniospinal Surgery Patients

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734362 ◽

2021 ◽

Author(s):

Pankaj Arora ◽

Kanica Rawat ◽

Rajiv Azad ◽

Kehkashan Chouhan

Keyword(s):

Magnetic Resonance Imaging ◽

Cerebrospinal Fluid ◽

Magnetic Resonance ◽

Clinical Outcome ◽

Phase Contrast ◽

Flow Dynamics ◽

Resonance Imaging ◽

Csf Flow ◽

Group I ◽

Group Ii

Abstract Objective Aim of this study is to evaluate the effect of craniospinal interventions on cerebrospinal fluid (CSF) flow hydrodynamics and study the correlation of postoperative changes in flow alteration with clinical outcome. Materials and Methods Fifty patients who underwent various craniospinal procedures were studied using conventional and phase-contrast magnetic resonance imaging (PCMRI) protocol. CSF flow quantification was performed at cerebral aqueduct, foramen magnum, C2–3, and D12–L1 vertebral levels with site showing maximal alteration of CSF flow dynamics considered as the region of interest. Velocity encoding was kept at 20 cm/s. Patients with pathology atcraniovertebral junction were considered separately (group I) from others (group II) due to different flow dynamics. Follow-up scans were performed after an interval of 1 month for temporal evaluation of changes in CSF flow dynamics. Results Patients in both groups showed a significant change in peak CSF velocity postoperatively (mean change of 1.34 cm/s in group I and 0.28 cm/s in group II) with bidirectional improvement in flow on cine-phase-contrast qualitative images. Regional pain (82%) and headache (46%) were seen in most of the patients preoperatively. Postoperatively clinical symptoms improved in 59.5%, static in 26.2%, and worsened in 14.3%. In both the groups, an improvement in clinical symptomatology had significant correlation with mean changes in peak CSF velocity postoperatively (p = 0.04 in both groups). Conclusion PCMRI can effectively evaluate changes in CSF flow noninvasively both pre- and postoperatively. This may have potential role in determining clinical outcome and prognosis of patients undergoing procedures in craniospinal axis.

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