[Intracranial arachnoid cyst [review of 20 cases]]

The purpose of this study is to evaluate the distribution, clinical features, and treatment modalities of arachnoid cyst in our department. The study was carried out between April 1, 1996 and October 1, 2006 in the neurosurgery department, Ghaem hospital, Mashhad University of Medical Sciences. Twenty patients with arachnoid cyst underwent surgery between April 1, 1996 until October 1, 2006, consisting of 12 males and 8 females aged 5 to 68 years [mean age 32.4 years]. Twelve patients underwent surgery and one patient underwent endoscopic fenestration, and cystoperitoneal shunting [medium pressure] was performed in 7 patients. All patients were followed for minimum of 6 months after surgery. During the study period, 20 patients were investigated. The cysts location was the middle cranial fossa in 12 patients [60%], suprasellar region in 1 patient [5%], the cerebral convexity in 1 patient [5%], posterior cranial fossa in 2 patients [10%], cerebellopontine angle in 3 patients [15%], and quadrigeminal cisterns in 1 patient [5%]. All cysts had clearly unilateral distribution, 12 [60%] were located on the left side and 8 [40%] on the right side. The most common symptoms on presentation were epileptic seizures [46%], increased intracranial pressure [34%], visual impairment [5%], headache [10%], and cerebellar signs [5%]. Arachnoid cysts have a strong predilection for the middle cranial fossa which may be explained by a meningeal mal-development theory. We also conclude that the major indication for surgery in patients with arachnoid cyst is the presence of intractable seizures, increased intracranial pressure, and compression of nervous tissues. Headache is not a surgical indication on its own

Report of 4 cases of the diastematomyelia diagnosis by MRI during one year

Diastematomyelia is one of the uncomon and occult spinal dysraphisms. The term is derived from two latin word: diastemato means split and myelous means cord. The pathological characteristics consist of longitudinal cleft in the spinal cord of the lower thoracic and upper lumbar spinal column in children and rarely in adults. This report has encountered with 4 cases during one year [2003-2004] in M.R.I, centers of university and private clinic that MRI showing a midline dimple shape and hemicord appearance. This study and article found that patient diagnosis with MRI is more reliable and more accurate than other radiological techniques specially CT scanning, because of multisectional and multiplanners for a better view of the lesion. In this study most of patients are a female infant with a majority of clinical neurologic findings including motor and sensory loss in the lower extremities and bladder dysfunction