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Paramesencephalic arachnoid cysts

From the Departments of Neurological Surgery and Radiology, University of California School of Medicine, San Francisco.

The term "paramesencephalic" is proposed to describe the location of a general class of arachnoid cysts observed in four patients. These cysts, which appear to arise within the subarachnoid space, are characterized by a lack of communication with the ventricular system. Usually, the arachnoid tissue is normal, and the cyst fluid resembles cerebrospinal fluid both macroscopically and microscopically. Hydrocephalus is variably accompanied by localizing signs. Problems may be encountered in the diagnosis of suprasellar (case 4), parapineal (case 3), incisural (case 1), and interpeduncular (cases 2 and 4) arachnoid cysts. Early surgical exploration is strongly recommended.

Reprint requests should be addressed to Dr. Wilson, Department of Neurological Surgery, University of California School of Medicine, San Francisco, CA 94143.

This work was supported in part by NIH NINCDS training grant No. 5593.

Received for publication March 14, 1975.