Retrocerebellar cyst of the brain: what is it?
Retrocerebellar licorna a brain cyst – benign neoplasm of the hollow, inside of which is a liquid – the cerebrospinal fluid. It occurs in the place of death of cells of the gray matter. Most often this cyst is located behind the cerebellum.
Retrocerebellar arachnoid cyst – pathology, which affects not only the brain substance and the arachnoid of the brain.
Etiology of education
Retrocerebellar cyst can be congenital or acquired pathology. The acquired form may occur for many reasons:
- due to violations of cerebral circulation (ischemia of the part of the brain and its consequences – strokes);
- as a result of traumatic brain injury;
- the fault infectious diseases affecting the brain or its membranes (e.g., meningitis, meningoencephalitis);
- as the negative effects of surgery.
In appearance a congenital form of the cyst plays a role of a genetic factor, as well as any abnormalities during pregnancy leading to developmental defects. Often this cyst is one of the manifestations malformation Dandy-Walker (congenital malformations of the cerebellum and surrounding liquor space).
Classification of cysts
Origin – congenital and acquired pathology.
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- retrocerebellar – develops at the site of the death of gray brain matter, mainly in the cerebellum (what is the reason for its name);
- arachnoid – occurs between the meninges;
- retrocerebellar arachnoid (combined) – at the same time affects the arachnoid and the brain.
The pathogenesis of the disease
The formation of cystic cavity in the place of dead cells can be considered a protective reaction to injury, which is designed to protect healthy cells. However, such a barrier is often only worsens the situation. The process itself begins to move in «circles». The walls of the cyst put pressure on surrounding tissue, again, starts the blood circulation in these tissues, cells die and cyst is growing.
Most nonspecific symptoms caused due to disorders of the circulation of cerebrospinal fluid in the brain, causing increased intracranial pressure and secondary hydrocephalus develops. Focal symptoms caused by compression of the cyst is of large size a particular area of the brain. Growing, it presses on nearby parts of the brain, thereby disrupting their functioning and structure. Often contributes to further cell death.
Signs retrocerebellar cysts may be different. It depends on the location of the tumor, its size and growth rate. At the initial stage of disease the first symptoms appear – headache, bloating or squeezing, throbbing in the head. Possible nausea and vomiting not associated with food intake. Depending on the place of formation of the cyst may develop transient visual disturbances or hearing.
If retrocerebellar the cyst gradually increases in size, and the pressure of the liquid in it increases, symptoms actively growing. This files most often contribute to autoimmune pathology and active infection. The patient’s condition worsens, there are signs of serious violations:
- the pulsation in my temples and severe headaches that cannot be relieve medicinal means;
- sudden fainting;
- frequent violations by hearing the sharp noise in the ears, hearing loss;
- disorders of the organs of sight – flies flashing before my eyes, the appearance of visual spots, double vision and blurred contours;
- unsteadiness of gait and equilibrium disturbances;
- epileptic seizures and convulsions;
- paresis and paralysis of extremities;
- paresthesias, especially numbness of the limbs or body parts;
- mental disorders – lethargy, sleep disorder, weakness, irritability and nervousness.
If the cyst is small and does not increase, the disease may be asymptomatic, especially at the initial stage, which is very difficult to diagnose pathology.
Asymptomatic disease is characteristic of congenital retrocerebellar cysts. And only in the case of a large congenital cystic tumors already in childhood manifested specific symptoms:
- tremor (shaking) of the limbs;
- nystagmus (rhythmic jerking of the eyeballs);
- slurred speech (slow or fragmented speech);
- hypotonia (muscle weakness);
- shaky, unsteady gait.
Diagnosis of the disease
On the basis of only one symptom the diagnosis is impossible. Therefore, the patient must undergo a special examination.
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- MRI (magnetic resonance imaging) can reveal the localization and size of the cyst.
- CT (computed tomography) in addition to the confirmation of a cyst will help to determine the nature and character of the tumor. A survey carried out using a contrast substance that is injected into the body by lumbar puncture. A benign tumor does not accumulate in itself a token, in contrast to pathology, malignant course.
- Doppler ultrasound of vessels of head and neck necessary in the case when there is a disturbance of cerebral circulation. It can be used to identify areas of narrowing of the arteries, which cause lack of blood supply and subsequent death of brain cells.
- EEG (echoencephalography) helps to identify the possible consequences of the disease, and diagnose congenital retrocerebellar the cyst. This survey is carried out to all newborns with any disorders of the brain.
- Complete blood count and laboratory examination of the cerebrospinal fluid allow to establish the origin of the cysts to detect autoimmune diseases and to identify the infection.
- Blood clotting and biochemical analysis to determine the level of cholesterol in the blood. If improving performance in these two tests increases the risk of clogging of blood vessels with subsequent poor circulation.
- Monitoring blood pressure allows you to control its surges, which can lead to the development of movements and formation of cysts.
Treatment of cysts
If the disease is asymptomatic and does not cause any discomfort to the patient, and the cyst is small and not growing, treatment is not assigned. In such cases it is enough to be observed at the neurologist’s place of residence and to control the growth of tumors. If there are any complaints from the patient retrocerebellar the cyst in the initial stage is subject to conservative treatment methods. The drugs are selected depending on the causes of the emergence of pathology.
If the cyst is non-infectious type, prescribe medication that can improve circulation and provide for the resorption of scars and wrinkles. In the presence of infectious processes shown antibiotics, antiviral drugs, and immunomodulators that enhance the immune system.
For high blood pressure prescribed antihypertensive drugs, such as Capoten or enalapril. To improve microcirculation and blood rheology are shown taking Aspirin and Pentoxifylline. For violation supply of the brain with oxygen and glucose are prescribed nootropic drugs. If the appearance of a cyst caused by neuroinfection, conservative treatment is ineffective. In such cases it is often necessary to resort to surgical intervention.
In what cases is surgery indicated
There are two main indications for surgery:
- drug therapy is aimed at reducing the size of the cyst, or no results;
- there is strong growth in tumors, which leads to severe disturbances of brain activity (the development of paralysis, severe pain, etc.).
Types of operations
The choice of the type of surgery depends on the location of the cyst and its size. There are three types of surgical intervention:
- Endoscopic surgery. Considered the most modern and less traumatic method of surgical treatment. It is a microsurgery which is carried out using endoscope and surgical instruments. Through a small hole-a puncture in the skull introduces the endoscope, then the tools made a small incision on the wall of the cyst and the liquid is drawn off. Such an operation can not be performed in malignant tumors. And it is not always possible to get cysts, which are quite deep inside the brain.
- Intracranial bypass surgery. This type of operation is resorted to at frequent relapses of the disease, when there is a constant flow of liquid. The fluid from the cyst using a special shunt is withdrawn in the other cavity, for which its presence is considered a natural.
- Neurosurgical operation to remove a cyst. There is opening the skull (craniotomy). The cyst is completely removed. This operation is quite traumatic, but it eliminates the recurrence of the disease and gives the chances of a full recovery of the patient. This surgery can be performed in case if the cyst is in a place accessible to the craniotomy.
In the postoperative period, the physician is required to appoint maintenance therapy: vitamins and medicines, whose action is aimed at strengthening of vascular walls and improve microcirculation of blood and cerebrospinal fluid.