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CLINICAL ANALYSIS OF THE ARACHNOID CYSTS IN THE MIDDLE FOSSA Takashi Hayashi 1 , Shigeyuki Anegawa 1 , Eiichiro Honda 1 , Shinken Kuramoto 1 , Koreaki Mori 2 , Takaho Murata 2 , Soichi Miwa 2 , Hajime Handa 2 1Department of Neurosurgery, Kurume University School of Medicine 2Department of Neurosurgery, Kyoto University Medical School pp.205-214
Published Date 1979/2/1
DOI https://doi.org/10.11477/mf.1406204378
  • Abstract
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Intraarachnoid cyst may occur in every site where the arachnoid exits, and it can be seen in the middle fossa, convexity, interhemisphere, parasellar, cerebellopontine angle and retrocerebellar regions. Among them, there is a high incidence of arachnoid cyst in the middle fossa, and is diversely charac-terized by its clinical symptoms and radiological findings. Further, arachnoid cyst in the middle fossa is associated with some agenetic state of the temporal lobe and its adjacent tissue. There are two theories on the pathogenesis of this cyst. One theory is that a localized defect of the temporal lobe is producted due to congenital anomary in opercularization, and an abnormal dilatation of the arachnoid space coinciding with the defective partoccurs, which forms a cyst after its loculation (subarachnoid cyst). The other theory is that an intra-arachnoid cyst is formed due to anomaly in systemic genetic process of the subarachnoid space, and because of the diturbance of opercularization, a localized arrest of the development of the temporal lobe is caused.

This paper describes the clinical analyses and radiological findings of 12 cases of " idiopathic" arachnoid cysts in the middle fossa encountered during the past 12 years. Their results were following.

1. The ages of the patients in 10 cases out of 12 cases were under 15 years of age, and 8 cases were males. The site of the cyst was on the left side in 9 cases.

2. On the plain skull radiography, thinning and bulging of the temporal bone at the lesion, elevation of the lesser wing of the sphenoid, and forward projection of the greater wing of the sphenoid were observed in all cases.

3. On cerebral angiography, a characteristic elevation of the middle cerebral artery and hypo-plasty of the insular portion and opercular portion were observed; and on venous phase, a defect of the middle cerebral vein, backward deviation of the Labbe' vein, and elevation of the Rosenthal vein were seen.

4. On Amipaque CT cisternography, there were two types, one was communicable and other was non-communicable between the cyst and its adjacent subarachnoid space.

Of the 12 cases the authors experienced there were those with diffuse arachnoid cyst extending to the whole skull base and those with retro-cerebellar cyst. Also the authors observed other intracranial disease such as chronic subdural hematoma and hydrocephalus in the arachnoid cysts.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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