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Case Reports
. 2019 Sep 27:10:189.
doi: 10.25259/SNI_380_2019. eCollection 2019.

Symptomatic foramen of Magendie arachnoid cyst in an elderly patient: The second case report in the literature

Ítalo Teles de Oliveira Filho  1 , Paulo Cesar Romero  2 , Emílio Afonso França Fontoura  2 , Saul Dalla de Oliveira  2 , Ricardo Vieira Botelho  3
Affiliations
Case Reports

Symptomatic foramen of Magendie arachnoid cyst in an elderly patient: The second case report in the literature

Ítalo Teles de Oliveira Filho et al. Surg Neurol Int. .

Abstract

Background: Arachnoid cysts are benign extra-axial lesions corresponding to 1% of intracranial expansive lesions. They are usually incidental findings in asymptomatic patients. Most cases are congenital, and when symptomatic are diagnosed in childhood or adolescence. Symptomatic arachnoids cyst in elderly patients is very rare. This report documents the second case in the literature of a symptomatic elderly patient with an arachnoid cyst located in the foramen of Magendie.

Case description: A 68-year-old male had weakness in the lower limbs, imbalance, and gait disturbance for 3 years, associated with frequent falls. The patient complained of paresthesia in the upper right limb and right hemiface. An magnetic resonance imaging showed a massive cystic lesion in the posterior fossa in the foramen of Magendie. A median suboccipital craniectomy was performed, and the cyst was removed.

Conclusion: This case report adds to the literature the second case of a patient with a symptomatic arachnoid cyst in the posterior fossa successfully treated by surgery.

Keywords: Arachnoid cyst; Elderly; Foramen of Magendie; Midline; Posterior fossa.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
(a and b) Preoperative magnetic resonance imaging. The sagittal and axial section on T2-weighted image showing a large cyst with an intensity similar to the cerebrospinal fluid in the posterior fossa with severe compression of the cerebellum and brainstem.
Figure 2:
Figure 2:
Intraoperative microscopic view. (a) The appearance of the cyst wall after dura mater opening. (b) Brainstem posterior surface after cyst wall removal.
Figure 3:
Figure 3:
(a and b) The anatomopathological examination with hematoxylin and eosin showed loose fibrous wall cyst lined by flattened meningothelial cells.
Figure 4:
Figure 4:
(a and b) Postoperative magnetic resonance imaging. Sagittal and axial section of on T2-weighted image revealing the reduction of the cyst size and a significant decrease in the compression on the brainstem and cerebellum.
See this image and copyright information in PMC

References

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