Front Cover

Arachnoid Cysts

Copyright Page

Dedication

Contents

List of Contributors

Preface—Volume 1

I. Introduction

1 Arachnoid Cysts—Historical Perspectives and Controversial Aspects

Abbreviations

The Early History

The First Observation and Description of an AC

Where Were the Early Cysts Located?

Arachnoid Cysts and Imaging

Skull X-Ray and Angiograms

The CT Era

Arachnoid Cysts: Controversies and Misconceptions

The Reluctance to Operate ACs—Can It Be Explained From the History?

The Big Mistake—The Temporal Lobe Agenesis Syndrome

Other Misconceptions

References

II. Biological aspects

2 Arachnoid Cysts—Intracranial Locations, Gender, and Sidedness

Abbreviations

Introduction

Anatomical Location, Sidedness, and Gender Distribution in Large Series of AC Patients

Anatomical Location of ACs

Sidedness and Gender

Discussion

References

3 Molecular Biology and Genetics: Gene Expression, Twin Studies and Familial Occurrence, and Syndromes Associated With AC

Abbreviations

Introduction

Review of the Literature

Syndromes Associated With Arachnoid Cysts

Twin Studies and Familial Occurrence

Studies on Gene Expression

Conclusion

References

4 Arachnoid Cysts in Glutaric Aciduria Type I (GA-I)

Abbreviations

Level of Evidence I

Level of Evidence II

Introduction

Genetics

Metabolic Derangement

Pathophysiologic Concepts

Clinical Presentation and Natural Disease Course

Diagnosis

Neuroradiologic Abnormalities

Subdural Hemorrhage and Arachnoid Cysts in GA-I

Treatment and Prognosis

Future Perspective

References

5 Ultrastructure of Arachnoid Cysts

Abbreviations

Introduction

Ultrastructure of the Arachnoid Membrane

Immunohistochemistry of AC

Ultrastructure of AC

ACs With Arachnoid-Like Morphology (Type I)

Arachnoid Cysts With Fibrous Morphology (Type II)

Arachnoid Cysts With Aberrant Morphology (Type III)

Differential Diagnosis

Summary

References

6 Pathophysiology of Intracranial Arachnoid Cysts: Hypoperfusion of Adjacent Cortex

Abbreviations

Introduction

Influence of Arachnoid Cyst on Brain Function

Intracranial Hypertension

Altered Cerebral Perfusion and Metabolism

MR Imaging Characteristics in DWI

Functional MR Imaging in ACs

References

7 Biochemistry—Composition of and Possible Mechanisms for Production of Arachnoid Cyst Fluid

Abbreviations

Background

Theories of Filling Mechanism

Biochemical Studies

Osmotic Pressure Mechanism

Valve Mechanism

Active Transport

References

8 The “Valve Mechanism”

Abbreviations

Recommendations—Level of Evidence

Levels I–III

Level IV

Introduction

Historical Background

Communication With Subarachnoid Space

“Slit-Valve Mechanism”

Controversies

References

III. Prevalence and Natural History of Arachnoid Cysts

9 The Prevalence of Intracranial Arachnoid Cysts

Abbreviations

References

10 Classification and Location of Arachnoid Cysts

Abbreviations

Introduction

Classification of Middle Fossa Temporal Cysts—Galassi Classification

Other Locations

Suprasellar Cysts

References

11 Growth and Disappearance of Arachnoid Cysts

Abbreviations

Recommendations—Level of Evidence

Level I

Level II

Level III

Spontaneous Disappearance or Reduction of Cysts

Postnatal Development of De Novo ACs and Growth of an Established AC

Postnatal Development of De Novo ACs

Postnatal Growth of an Already Established AC

Conclusive Remarks

References

12 Arachnoid Cysts and Subdural and Intracystic Hematomas

Abbreviations

Introduction

What Is The Frequency/Prevalence of Extracerebral Hematomas in AC Patients?

How Often are ACs Found in Patients With a CSDH and Where Are These Cyst Located?

How Often Are Chronic Extracerebral Hematomas Found in Patients With an AC and Which Cyst Locations Predispose for Such Hem...

Should We Then Operate Arachnoid Cysts to Prevent the Development of Future Hematomas?

Who Are at Risk of Getting Spontaneous Hematomas Associated With an AC?

Age Doesn’t Seem to Matter

Does Gender Matter?

Cyst Location—Middle Fossa Cysts Are Overrepresented in Patients With Extracerebral Hematomas

Does Cyst Size Matter?

Prior Head Injury

What Are the Possible Mechanisms Behind the Bleeding?

How Dangerous Are Spontaneous Extracerebral Hematomas in AC Patients?

Which Surgical Procedures Have Been Used?

Intracranial Aneurysms and AC - Is There an Association?

Can Extracerebral Hematomas in AC Patients Be Misinterpreted as Having Been Caused by Physical Child Abuse?

References

13 Hydrocephalus Associated With Arachnoid Cysts

Abbreviations

Introduction

Material and Methods

Embryopathogenesis of AC-Related Hydrocephalus

ACs and the Subarachnoid Spaces

Pathogenesis of AC-Associated Hydrocephalus

Epidemiological Data of ACs With Hydrocephalus

Arachnoid Cyst Overview

Arachnoid Cyst-Related Hydrocephalus

Significance of Macrocephaly in ACs

Hydrocephalus Associated With ACs

Diagnosis of AC-Related Hydrocephalus

Management Options for Hydrocephalus in ACs

Conservative Management

Surgical Management Options

Surgical Options According to AC Location

Outcome

Conclusions

References

Further Reading

IV. Neuroimaging

14 Radiological Workup, CT, MRI

Recommendations—Level of Evidence

Level I

Level II

Introduction

Imaging Techniques

Computed Tomography

Magnetic Resonance Imaging

Cisternography

Detection

Differential Diagnosis

Delineation

Pretreatment Evaluation

Evaluation After Surgery

References

15 Arachnoid Cyst—Prenatal Detection, Management, and Perinatal Outcome

Abbreviations

Recommendations—Level of Evidence

Level I

Level II

Background

Ultrasound Diagnosis

Postnatal Workup

Outcome of Arachnoid Cysts

Surgery

Summary

References

16 SPECT Studies in Patients With Arachnoid Cysts

Abbreviations

Introduction

Patients and Methods

Results of SPECT Studies

Own Experience

Literature Review

Discussion

Significance of Functional Studies for Deciding AC Surgery

Isotope-Based Studies in the Assessment of AC Pathology

SPECT

Conclusions

References

Index

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