h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

About a year ago my wife was told, very much in passing by the sort of consultant who should be shot, that she had a brain cyst. Have discovered that 'cyst' is not the same as 'tumour' and it may be quite benign. But we have so many questions the helpful consultant (interesting the words you can get if you abbreviate 'consultant&#39 failed to answer. The MRI scan Raven had looking for trapped nerves in the back of her neck/right shoulder area, but I now realise nobody has told us what sort of cyst it is. Or what it might do exactly. Or whether it might ever go away. Or what the chances are of damage or the need for surgery and how risky the surgery is.
If anyone has any, even remotely speculative, answers to these questions I would be very grateful.

Hi Benjiman.

You've not given me enough information to give any sort of reliable information. Was their any other description given about. the brain cyst, an adjective of some sort? If I knew the exact wording of the report I may be able to offer general information the sort of cyst, but I can't really at the moment.

About 1 in 20 people have something on a brain scan that isn't quite normal, but has probably always been there, is causing no trouble, and is not going to go on to cause any trouble. You know how we all have different noses? Well the more scans we do the more we find out that we all have different things inside our brain.

Seriously, you and your wife have clearly not been given enough information here and you need to find out mor - from not from the internet. I would suggest that given that the consultant that you saw was not helpful you ask your GP if they have any more information. The consultant will have written to the GP and they may well have enough information to be able to advise you. If they haven't I suggest you ask for a second opinion.

Hi Z. Yeah, the more I read, or try to read, the more it becomes glaringly apparent that we barely have a clue what is going on here. Will take your advice and talk to GP who is a sound, sensible, honest bloke who will calm our fears if he can and tell us all that he knows. Thanks for the reply all the same.

Okay guys, I'm back, and now with proper information:

It is apparently an arachnoid cyst (or may be) and is (definitely) adjacent to the anterior aspect of the left temporal lobe. According to the consultant's letter, R does not have a CP angle lesion. Can anyone translate any of this?

Yes, I'll post more when I've got a little time.

Thanks Z.

Still not forgotten, it's not 100% my area - my current research is into blood vessels in the brain, not into cysts, I've found a couple of papers which seem useful, but I need to double check the facts first. I don't want to give you duff information.

Thanks again. Very much appreciate your efforts.

Right Arachnoid Cysts:

I got most of this information from an excellent article I was able to access through my university library - Intracranial arachnoid cysts: Current concepts and treatment alternatives, it was published in Clinical Neurology and Neurosurgery in 2007 (Vol 109, Issue 9, page 837 - should you be interested).

I don't believe that there has been a great deal of research since then which would change things, but there may be something I have missed.

A cyst is a term for an cavity in the body which is filled with fluid, it doesn't have to be abnormal, the bladder is often referred to as a cyst - that's why you get cystitis - inflammation of the cyst.

The brain is in the your skull, it's covered by an arachniod membrane and then there's a layer of Cerebrospinal fluid, that's called CSF. That means that the brain is less likely to get damaged when you get a head injury.

An arachnoid cysts is where there's a small hole in the brain which is lined by arachnoid membrane and has CSF in. Often they've been there since childhood, and they are picked up by scans that you have for another reason. Usually they don't get a lot bigger, and sometimes they get smaller.

Sometimes they do occur in a place that causes symptoms, in which case they need surgery, although this is quite routine to a brain surgery, however all brain surgery is a bit risky and includes risks of brain damage and stroke. I would avoid neurosurgeons like the plague unless the alternative is death or serious disability.

Before considering neurosurgery you need to be sure that the cyst is causing the symptoms. So you need to know that the symptoms are related to the part of the brain where the cyst is. If the cyst is on the left and the symptoms are related to the left of the brain then you do not want to go near the cyst with a surgeon.

The reference to the Cebropointine angle, also know as the CP angle: that's a part of the brain where the Pons joins the cerebellum. It's where a number of nerves leave the brain, so If you have a tumour (or a cyst) around this place then you have a constellation of weird symptoms and dizziness. There must have been a reason why the consultant was particularly interesting in that area of the brain, perhaps some of her symptoms were related to that area.



Now for the next question - what to do. Well that's where I can't help with - this is all information not advice, I can't tell you what your wife should do with that information - other than discuss things with her doctor as she already has done.

Wow. Thanks Z that's really helpful and I understood pretty well all of it. I don't really expect 'what shall we do?' type answers and it really was a very unfair question. I feel quite a lot better for knowing what the hell is going, in which you have been immeasurably helpful. We shall be seeing a neurologist (I think) at some point for a formal professional opinion and hopefuly R's opthamologists will be able to agree whether her partial sight loss (in her right eye) is cyst related or not. Just a couple more questions if you (or any other passing h2g2 boffin) will indulge me:
1) What's the pons?
2) Which bit is the cerbellum?
3) What does 'anterior aspect of the left temporal lobe' mean? Is that just doctor speak for at the back on the left?

Thanks again Z, you've been hugely helpful.

Hi Ben

Hopefully it *won't* need surgery.

1 - the pons - part of the brain stem where the cranial nerve nuclei are - they're the nerves that come directly from the brain and not the spinal cord.

2. The cerebellum is the bit at the back of the brain that co-ordinates movement, speech and other things.

3. The anterior aspect of the left temporal lobe, it' s the bit at the front of the middle bit on the left. It's easier to say 'anterior aspect of left temporal lobe'.