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Images in Neurology |

Growing Posterior Fossa Arachnoid Cyst Causing Tonsillar Herniation and Hydrocephalus

Satoshi Kurabe, MD; Osamu Sasaki, MD; Daiju Mitsuhashi, MD; Tetsuo Koike, MD
Arch Neurol. 2011;68(12):1606-1607. doi:10.1001/archneurol.2011.749.
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A 25-year-old woman without any significant medical or traumatic history presented with a 1-month episode of recurrent and progressive bioccipital headaches and nausea. At age 18 years, she had been investigated for occasional bitemporal headache in a local clinic, and a 1 × 1-cm retrocerebellar cyst had been incidentally detected on magnetic resonance imaging (Figure, A). The lesion was considered to be of no significance with regard to her symptoms at that time and thus was left untreated.

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Figure. Magnetic resonance images and an intraoperative photograph. A, Axial T2-weighted magnetic resonance image obtained 7 years prior to the current admission showing a 1 × 1-cm retrocerebellar cyst. B, Axial constructive interference in steady state magnetic resonance image showing a 4 × 5-cm retrocerebellar cyst. C, Postcontrast sagittal T1-weighted magnetic resonance image showing a 4 × 5-cm retrocerebellar cyst and tonsillar herniation. D, Intraoperative photograph showing a bulging cyst that contained a xanthochromic fluid.




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