Hassan Mostafa Jaber, Ismail Ali, Salman Iyas, Salman Ali, Salman Issam
Department of Neurosurgery, Tartous University, Tartous, Syrian Arab Republic.
Department of Neurosurgery, Tartous University, Tartous, Syrian Arab Republic.
Int J Surg Case Rep. 2025 Apr 25;131:111373. doi: 10.1016/j.ijscr.2025.111373.
Cystic lesions in the brain, often seen in MRI and CT scans, may arise from various causes, including developmental issues, infections, or tumors. Differentiating between arachnoid cysts and hydatid cysts is critical for effective management, as misdiagnosis can lead to inappropriate treatments and worsen patient outcomes.
An 18-year-old right-handed female from a rural area experienced a right-sided focal seizure lasting two minutes. Her history includes progressive right-hand pain, worsening writing difficulty, persistent headaches, personality changes, and recent memory impairment. She had slurred speech. Radiological examination revealed a massive cystic lesion in the brain which initially appeared to be a hydatid cyst, but histological examination revealed it to be an arachnoid cyst.
Arachnoid cysts, comprising about 1 % of intracranial masses, are commonly found fluid-filled sacs located in the arachnoid mater, usually incidentally discovered during imaging. They are more frequent in children and males, often asymptomatic but can cause symptoms based on their location. Classification includes congenital and traumatic types, with congenital being more common. Diagnosis can be challenging, especially when symptoms overlap with conditions like hydatid cysts, complicating treatment decisions.
Arachnoid and hydatid cysts appear similar in surgery and may be hard to distinguish. Dissection difficulty should be the main way to differentiate them. A hydatid cyst diagnosis should not be ruled out until multiple attempts by an experienced surgeon have been made. Further studies are needed to clarify these findings.
脑部囊性病变在MRI和CT扫描中经常可见，其可能由多种原因引起，包括发育问题、感染或肿瘤。区分蛛网膜囊肿和包虫囊肿对于有效治疗至关重要，因为误诊可能导致不恰当的治疗并使患者预后恶化。
一名来自农村地区的18岁右利手女性经历了一次持续两分钟的右侧局灶性癫痫发作。她的病史包括右手渐进性疼痛、书写困难加重、持续性头痛、性格改变以及近期记忆力减退。她说话含糊不清。影像学检查显示脑部有一个巨大的囊性病变，最初看起来像是一个包虫囊肿，但组织学检查显示它是一个蛛网膜囊肿。
蛛网膜囊肿约占颅内肿块的1%，通常是位于蛛网膜下腔的充满液体的囊袋，常在影像学检查时偶然发现。它们在儿童和男性中更为常见，通常无症状，但可因其位置而引起症状。分类包括先天性和外伤性类型，先天性更为常见。诊断可能具有挑战性，尤其是当症状与包虫囊肿等疾病重叠时，会使治疗决策复杂化。
蛛网膜囊肿和包虫囊肿在手术中外观相似，可能难以区分。解剖难度应是区分它们的主要方法。在经验丰富的外科医生多次尝试之前，不应排除包虫囊肿的诊断。需要进一步研究来阐明这些发现。
