Surgical Treatment of Arachnoid Cysts in a Patient With Psychosis – A Case Report and Literature Review

Abstract

Arachnoid cysts are relatively rare intracranial disorders. They frequently give no symptoms and do not require neurosurgical treatment [7, 8]. For some particularly large cysts, neurological symptoms may occur, which may indicate the need for surgical intervention. This paper describes the case of a 32-year-old man with an extensive arachnoid cyst of the middle cranial fossa, suffering from paranoid schizophrenia with positive symptoms. The patient underwent surgical treatment. By way of peritoneal craniotomy, the walls of the cyst were removed along with its connection to the cisterns of the subarachnoid space and of the lateral chamber. A follow-up CT scan performed on the fourth day after the procedure showed a minimal reduction in the size of the cyst. The patient after the surgery presented no positive symptoms; however dyskinesia occurred in the form of a hypokinetic - hypertonic syndrome, a slight and transient paresis of the left upper limb, and a depressed mood and decreased drive presenting as an apathic-abulic syndrome. In the course of further psychiatric treatment and rehabilitation, these symptoms gradually subsided. During the publication of this work, the patient is undergoing continued psychiatric treatment. Until the publication of this work, no further psychotic symptoms have been observed.