prof. Dr. Halil İbrahim Secer
Brain and Nerve Surgery (Neurosurgery)
Arachnoid Cysts:
The thin membrane that surrounds the brain and spinal cord is called the arachnoid membrane. Since this membrane resembles a spider web in the microscope, it is called arachnoid membrane, meaning spider-like in Ancient Greek.
Arachnoid cysts can develop wherever the arachnoid membrane is present. Arachnoid cysts constitute 1% of intracranial space-occupying formations. In autopsies, this ratio is 1/1000. They usually show symptoms before the age of 20 and are seen 2-3 times more in boys than girls. In a joint study conducted in Europe, the average age of onset of axes was found to be 6 years.
When and how do arachnoid cysts form?
The vast majority of arachnoid cysts are congenital. In other words, it occurs with the accumulation of fluid in this region as a result of the separation of the arachnoid membrane in the mother's womb before birth. At the 15th week of pregnancy in the mother's womb, cerebrospinal fluid (CSF) begins to circulate under the arachnoid membrane. From this period, there is a possibility of arachnoid cyst development.
To a lesser extent, it is known to develop after head trauma (accident, fall) and after brain inflammatory diseases. Arachnoid cysts can develop anywhere in the brain where the arachnoid membrane is present.
Diagnosis
Today, the diagnosis is made by computed tomography (CT) or magnetic resonance imaging (MRI).
What Are the Symptoms of Arachnoid Cysts?
Headache and epilepsy are the most common complaints in these cysts. Sometimes they are detected in CT or MRI scans taken for other reasons, although they do not cause any complaints.
Arachnoid Cyst Treatment
Smaller type I cysts should be followed. Surgery is rarely required. It is necessary to check them with tomography or MR at various times. If necessary, surgery can be performed in larger Type II and III arachnoid cysts that cause epilepsy.
Bleeding may occur from trauma (fall, beating or traffic accident) into the cyst or between the brain and the thick (dura mater) membrane of the brain. Again, the cysts may open and spread under the thick membrane of the brain and give symptoms. In this case, surgery may be required.
Pineal Cysts:
The Pineal Gland is a tiny hormonal gland with dimensions of approximately 5-8 mm x 3-5 mm, deep in the brain, close to the back. After the kidneys, it is the second organ with the richest blood flow in the body. 1 gr. The pineal tissue is supplied with 4 milliliters of blood per minute. The pineal gland, which has an oval shape, is connected to the 3rd ventricle (brain cavity) of the brain with a stem (in 4 brain cavities, cerebrospinal fluid is made and it relieves the weight of the brain with its dynamic production-excretion system and protects the brain against impacts).
The cerebral cortex has 3 layers. Between these membranes are brain spaces. Sometimes these spaces can be excessively widened from normal. Pineal region cysts are usually benign cysts that develop in these spaces. It can be found in about 40% of people.
Two important hormones are secreted from the gland:
Serotonin has.
2-Melatonin : Melatonin hormone plays a role in the regulation of reproductive cycles.
Pineal Cysts developing on this gland can be of various diameters. Those up to 0.5 cm do not give any symptoms. Those larger than 0.5 cm should be followed. If there are complaints of headache, seizures, visual disturbances, hypersensitivity to light, it is necessary to consult a doctor.
The cyst can block the passageways of the brain fluid and cause an increase in the brain water, which we call Hydrocephalus. If it did not cause fluid collection (hydrocephalus); no treatment is required. Surgical treatment and drug treatment are unnecessary in this type of pineal cyst. It is sufficient to check the Brain MRI at various intervals.
If it has caused hydrocephalus, it should be treated surgically.