Psychiatric Manifestations of Arachnoid Cysts

Abstract

Arachnoid cysts (ACs) are generally congenital, primarily located in the middle fossa adjacent to the temporal lobes that have dense neuronal connections. Many case reports and case series results reveal that ACs can cause psychiatric and cognitive disorders. It has been reported that surgical cyst decompression will provide substantial clinical improvement, especially for cognitive disorders. In children with ACs, it is particularly important to consider surgical intervention in order to prevent irreversible mental function impairment as brain development continues. Some authors emphasize that there is sufficient evidence in the literature to support this philosophy. In the course of primary psychiatric disorders, it should be kept in mind that the symptoms are complex, and in the case of resistance to standard treatments, there may be presence of an intracranial AC. Neuroimaging should be used more frequently in psychiatry than is currently in practice. Well-known pharmacotherapy options are used in the treatment of psychiatric symptoms. When necessary, electroconvulsive therapy is used after sufficient assessment of the patient. Neuropsychological testing should be a part of the process for the diagnosis of and surgical indications for cognitive disorders and in evaluating patients in follow-up.