A Cyst Overview: Diagnosis and Treatment in New Jersey

A cyst is a sac that may be filled with air, fluid, or tissue. Cysts can happen anywhere on the body, and most are not cancerous. Some cysts in the brain or spine may not cause any symptoms. Centers for Neurosurgery, Spine & Orthopedics in Northern New Jersey provides accurate diagnoses, treatment advice, and effective treatment plans for brain cysts or spine cysts.

Arachnoid Cysts

Arachnoid cysts grow within the brain and less commonly within the spinal cord. Arachnoid cysts filled with cerebral spinal fluid are the most common type of brain cysts. They are benign, but if they become too large, they can cause symptoms or worse, can lead to brain damage. Arachnoid cysts are often congenital, or in rare cases, they can develop after childhood head trauma occurs. They are more common in males than in females.

Some patients discover they have an arachnoid cyst as an incidental finding from an imaging scan ordered for other medical conditions. Often brain cysts do not have any associated symptoms, but when symptomatic, can sometimes cause the following:

• Dizziness or vertigo
• Headaches
• Nausea
• Problems with vision, hearing, or balance
• Seizures

When an arachnoid cyst is present within the spinal cord, a patient may have back pain, muscle spasm, arm or leg pain and numbness, weakness or paralysis.

If a patient is experiencing any of the above symptoms, physicians will need to order a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan to diagnose the cause which could be an arachnoid cyst or other abnormalities.

Some arachnoid cysts are small and don’t cause any symptoms. If there are no symptoms, there is no need to remove the cyst. However, if a cyst continues to grow or causes symptoms, a CNSO neurosurgeon will use the least invasive surgical procedure to drain the cyst or remove it entirely.

Dermoid Cysts

A dermoid cyst is a sac of fluid and tissue that grows underneath the skin. It usually appears on the skin as a small, firm lump. In addition to fluid, dermoid cysts can contain bone, nerves, hair, or teeth. Dermoid cysts are congenital, which means they are present at birth. They are caused by layers of the skin not properly differentiating during fetal development. They can also be caused by injury or prior surgery.

Most often, dermoid cysts form in the head and neck. The most common type is a periorbital dermoid cyst, which occurs on the outside edge of a patient’s eyebrow. Dermoid cysts can also occur on the spine or within an ovary. Some patients with dermoid cysts do not experience any symptoms. If a patient does develop symptoms, they are typically dependent on the cyst’s location:

• A spinal dermoid cyst can cause weakness in the limbs, difficulty walking or incontinence.
• A periorbital dermoid cyst can cause swelling around the eyebrow.
• An ovarian dermoid cyst may cause pelvic pain.

Dermoid cysts are typically diagnosed after a physical exam and a CT scan. Dermoid cysts must be surgically removed because they will continuously enlarge and will rupture causing the need for emergency surgery. Occasionally dermoid cysts can become cancerous.

Epidermoid Cyst or Epidermoid Tumor of the Brain

Known as either an intracranial epidermoid cyst or an epidermoid brain tumor, epithelial cells can become trapped within the brain and form a mass. Filled with keratin and fluid, these cysts are surrounded by a thin outer layer. While an epidermoid cyst may develop before birth, it can also form after an injury or surgery. Epidermoid cysts are commonly found in the following areas:

• Pituitary gland
• Brain stem
• Skull bone

Epidermoid brain cysts grow slowly and are typically benign, but they can become cancerous in certain cases. These cysts can also place pressure on brain structures and may only be discovered when they’ve grown large enough to cause symptoms. Depending on the size and location, epidermoid cysts may be associated with the following symptoms:

• Headaches
• Tinnitus (ringing in the ears)
• Hearing loss
• Vision difficulties
• Seizures
• Trigeminal neuralgia (chronic, severe face pain)
• Involuntary face twitching

An epidermoid brain cyst may burst then leak its fluid causing the brain’s lining to become inflamed (aseptic meningitis). The patient will then become very symptomatic including febrile, “goofy”, lethargic, and become difficult to wake. Physicians may use MRI or CT brain scans to evaluate the cause of the symptoms, the diagnosis, size and location of the cause which may be a cyst, tumor, or infection. If the patient presents with aseptic meningitis, steroids may also be prescribed.

If an epidermoid brain cyst is found, surgical removal is the most common form of treatment. Epidermoid cysts can be completely removed by CNSO neurosurgeons using state-of-the-art surgical methods. For cysts surrounding or located close to arteries, blood vessels, highly fragile brain tissue, or cranial nerves, full removal may not be possible.

Colloid Cysts

This is a very rare type of benign cyst that develops in the third ventricle of the brain. The cause of colloid cysts is unknown. Because they are rarely found in children, they are thought to develop later in life. Colloid cysts are diagnosed via an MRI or CT scan.

Many colloid cysts are asymptomatic. Occasionally, patients will experience symptoms like:

• Headaches
• Nausea
• Blurry vision
• Hydrocephalus (fluid buildup in the brain)

If a colloid cyst is very small and asymptomatic, treatment may not be required. But if the colloid cyst is symptomatic, a CNSO neurosurgeon will drain a patient’s colloid cyst using minimally invasive techniques (MIS) or a procedure called an endoscopic craniotomy. If necessary a traditional craniotomy can be performed. In most cases, patients are expected to make a full recovery.

Pineal Cysts

A pineal cyst develops within the pineal gland which is located near the center of the brain. The pineal gland is responsible for secreting melatonin which regulates a person’s sleep cycle. Typically, pineal cysts do not cause any symptoms and do not require treatment. Some patients with pineal cysts may have symptoms such as:

• Headaches
• Vision problems
• Altered mental status

The causes of pineal cysts are unknown, but they more commonly occur in women most often present during 20 to 30 years of age. Typically, pineal cysts are discovered by accident during an imaging scan. Sometimes a pineal cyst can cause hydrocephalus or “water on the brain” by causing an obstruction to the natural drainage of cerebral spinal fluid out of the skull. Hydrocephalus causes altered mental status and is a surgical emergency. When a patient does need treatment for their symptoms, the cure is a neurosurgeon to drained or remove the cyst via a minimally invasive procedure, endoscopic procedure, or open craniotomy.

Schedule a Consultation for Cyst Diagnosis and Treatment

Patients with cysts can rely on the team at Centers for Neurosurgery, Spine & Orthopedics, (CNSO) to properly guide their treatment and alleviate their concerns. CNSO has board-certified neurosurgeons with extensive experience diagnosing and treating cysts and tumors within the brain and spine. To request an appointment at one of the offices in Northern NJ, contact Centers for Neurosurgery, Spine & Orthopedics today.