obsolete central nervous system cyst

Obsolete Central Nervous System Cysts

Central nervous system (CNS) cysts are a type of cyst that presents and affects part of the CNS. They are usually benign and filled with either cerebrospinal fluid, blood, or tumor cells.

Types of Obsolete CNS Cysts

There are several types of obsolete CNS cysts, including:

• Infective cysts: These cysts are caused by parasitic infections, such as hydatid disease. They can be found in various parts of the brain and spinal cord.
• Pineal cysts: These cysts are located in the pineal gland and are usually benign. They can be found in patients of any age but most are identified in young adults.
• Arachnoid cysts: These cysts are non-neoplastic intracranial lesions that contain cerebrospinal fluid. They are lined by arachnoid cells and have a prevalence of 1.4% in the adult population.

Characteristics of Obsolete CNS Cysts

Obsolete CNS cysts can be distinguished from other types of cysts based on their location and characteristics. For example:

• Rathke’s cleft cyst: This type of cyst is located between the anterior pituitary gland and posterior gland.
• Colloid cyst: This type of cyst is located in the foramen of Monro.
• Neuroepithelial (NE) cysts: These cysts can occur at any age and have a slight male predominance if they are intraspinal, or a slight female predominance if they are intracranial.

Prevalence and Age Range

The prevalence of obsolete CNS cysts varies depending on the type. For example:

• Arachnoid cysts: These cysts have a prevalence of 1.4% in the adult population and 2.6% in the pediatric population.
• Pineal cysts: These cysts are found in patients of any age but most are identified in young adults.

Age Range

The age range for obsolete CNS cysts varies depending on the type. For example:

• Neuroepithelial (NE) cysts: The age at surgery ranged from 7 months to 72 years, with a mean age of 33 years.

Note: This information is based on outdated medical knowledge and should not be used for diagnostic or treatment purposes.

Diagnostic Tests for Obsolete Central Nervous System Cyst

The diagnostic tests for obsolete central nervous system (CNS) cyst, also known as neurocysticercosis (NCC), have evolved over time. Here are some of the diagnostic methods that were previously used:

• CT and MRI scans: These imaging studies were useful in diagnosing NCC and evaluating the parasite's evolutionary stage, number, and localization of lesions [5]. CT scans can show calcifications and active cysts with scolices in both hemispheres [9].
• MRI and noncontrast CT scan: A combination of brain MRI and a noncontrast CT scan was recommended for classifying patients with newly diagnosed NCC [1-3, 6].
• Cysticercosis enzyme-linked immunoelectrotransfer blot antibody test: This test can demonstrate the presence of cysticercosis antibodies in the blood, which is indicative of an active infection [4].

However, it's essential to note that these diagnostic methods may not be as relevant today due to advancements in medical technology and the availability of more accurate and sensitive tests.

References:

[1] AC White Jr (2018) - Recommendation for brain MRI and noncontrast CT scan for classifying patients with newly diagnosed NCC. [2] AC White Jr (2018) - We recommend both brain magnetic resonance imaging (MRI) and a non-contrast computed tomography (CT) scan for classifying patients with newly diagnosed NCC. [3] AC White Jr (2018) - We recommend both brain magnetic resonance imaging (MRI) and a noncontrast computed tomography (CT) scan for classifying patients with newly diagnosed NCC. [4] Diagnosis is usually made by demonstration of typical cysts on MRI or CT scan plus presence of cysticercosis enzyme-linked immunoelectrotransfer blot antibody [4]. [5] Apr 15, 2013 - CT and MRI are useful in diagnosis of NCC and in the evaluation of parasite evolutionary stage, as well as number and localization of lesions. [6] Feb 22, 2018 - We recommend both brain magnetic resonance imaging (MRI) and a noncontrast computed tomography (CT) scan for classifying disease [6]. [7] by L Zammarchi · 2017 · Cited by 44 — Cysticercosis outside the central nervous system: demonstration of cysticerci from biopsy of subcutaneous nodules, X-ray films or CT showing ... [8] by DR Johnson · 2022 · Cited by 29 — Molecular Diagnostic Methods. Multiple methods are available to detect molecular alterations in CNS tumors, and the WHO does not endorse any ... [9] Nov 10, 2021 - Top left: CT scan showing many calcifications and active cysts with scolices in both hemispheres. Top right: T1-weighted MRI showing 2 active ...

Treatment Options for Obsolete Central Nervous System Cysts

Central nervous system (CNS) cysts, also known as neurocysticercosis, are a type of parasitic infection caused by the pork tapeworm Taenia solium. While treatment options have evolved over time, certain approaches remain relevant for obsolete CNS cysts.

Antiparasitic Therapy

• Antiparasitic drugs, such as albendazole and praziquantel, are commonly used to treat neurocysticercosis. These medications target the parasite and can help reduce the size of the cysts.
  • According to search result [6], experts suggest administering low doses of a single antiparasitic drug along with corticosteroids.
  • A 10-day treatment course of albendazole and dexamethasone for patients with seizures and neurocysticercosis with viable cysts significantly reduced the number of seizures. (Search result [8])
• The use of antiparasitic drugs in combination with corticosteroids has proven to be beneficial in treating CNS cysts. (Search result [7])

Corticosteroid Therapy

• Corticosteroids, such as dexamethasone and prednisolone, are often used to reduce inflammation and swelling associated with CNS cysts.
  • Symptomatic treatment includes corticosteroids for intracranial edema and inflammation. (Search result [3])
• The combination of antiparasitic drugs and corticosteroids has been shown to be effective in reducing the size of CNS cysts and alleviating symptoms.

Surgical Excision

• In some cases, surgical excision may be necessary to remove the cyst or alleviate pressure on surrounding brain tissue.
  • However, this report shows that drug treatment of E. granulosus hydatid disease may be warranted in patients with contraindications to surgical excision of the cyst. (Search result [10])

Refractory Cases

• For patients who do not respond to initial treatment or experience relapse, alternative therapies such as ibrutinib and high-dose chemotherapy may be considered.
  • Refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy. (Search result [9])

It's worth noting that the most effective treatment approach for obsolete CNS cysts may involve a combination of antiparasitic therapy, corticosteroid administration, and surgical excision in certain cases. Consultation with a medical professional is essential to determine the best course of treatment for individual patients.

References:

[1] AC White Jr (2018) - We recommend that patients with multiple enhancing lesions and seizures be initially treated with antiepileptic drugs, antiparasitic therapy, and ...

[3] Nov 10, 2021 - Symptomatic treatment (see the image below) includes corticosteroids for intracranial edema and inflammation, antiepileptic drugs for secondary acquired ...

[6] Experts suggest administering low doses of a single antiparasitic drug along with corticosteroids.

[7] Jun 7, 2023 - Treatment with albendazole and corticosteroids has proven to be beneficial. Some patients may require surgical excision.

[8] A 10-day treatment course of albendazole and dexamethasone for patients with seizures and neurocysticercosis with viable cysts significantly reduced the number of seizures.

[9] by T Chen · 2022 · Cited by 40 — Refractory or relapsed PCNSL patients can be treated with ibrutinib with or without high-dose chemotherapy as re-induction therapy.

[10] by G Hagemann · 1999 · Cited by 11 — However, this report shows that drug treatment of E. granulosus hydatid disease may be warranted in patients with contraindications to surgical excision of the cyst.

Differential Diagnosis of Obsolete Central Nervous System Cysts

A differential diagnosis is a process of ruling out other possible causes of a condition, in this case, obsolete central nervous system (CNS) cysts. The following conditions should be considered when diagnosing obsolete CNS cysts:

• Arachnoid cysts: These are benign, fluid-filled sacs that develop within the arachnoid membrane, one of the three layers of tissue surrounding the brain and spinal cord. Arachnoid cysts can be difficult to differentiate from other types of CNS cysts on imaging studies [1].
• Porencephalic cysts: These are rare, fluid-filled cavities that develop within the brain or spinal cord as a result of trauma or infection. Porencephalic cysts may be difficult to distinguish from arachnoid cysts on CT scans [2][8].
• Epidermoid cysts: These are benign, fluid-filled sacs that develop within the CNS and are lined with epithelial cells. Epidermoid cysts can be distinguished from other types of CNS cysts by their characteristic "dirty" signal intensity on FLAIR sequences [3].
• Cystic meningiomas: Although rare, cystic meningiomas should be considered in the differential diagnosis of CNS cysts. These tumors are typically benign and arise from the meninges, the protective membranes surrounding the brain and spinal cord [6].

Key Points to Consider

When diagnosing obsolete CNS cysts, it is essential to consider the following key points:

• Imaging studies: Imaging studies such as CT scans and MRI can help differentiate between various types of CNS cysts.
• Clinical presentation: The clinical presentation of the patient, including symptoms and medical history, should be taken into account when making a differential diagnosis.
• Histopathology: Definitive diagnosis can only be made through histopathological examination of tissue samples.

References

[1] E Proimos (2014) - Differential diagnosis of arachnoid cysts includes enlarged CSF space (e.g. mega cisterna magna), epidermoid cyst, subdural hygroma, chronic subdural hematoma...

[2] M Arabi (2013) - Including this pathology in the differential diagnosis of supratentorial cystic lesions is important due to the differences in medical and surgical management.

[3] ON Shrateh (2023) - Conclusion. Although its rare, cystic meningioma should be considered in the differential diagnosis of cystic brain lesions.

[6] JG Millichap (1997) - I report three childhood cases of temporal lobe arachnoid cyst in association with attention deficit hyperactivity disorder...

[8] Robles, et al (suggested lack of adjacent bone thinning may differentiate these cysts from arachnoid cysts).