A refractory arachnoid cyst presenting with tremor, expressive dysphasia, and cognitive decline.
BACKGROUND
Arachnoid cysts are common incidental findings on intracranial imaging, although they are rarely symptomatic.


METHODS
We present a case of a 49 year-old woman with a recurrent left supraorbital arachnoid cyst who developed staring spells, expressive dysphasia, and tremor after cyst fenestration and cystoperitoneal shunting. Her symptoms resolved after removing the shunt valve and creating a valveless system. The case is discussed and the literature reviewed.


CONCLUSIONS
We present a case of a recurrent arachnoid cyst that developed worsening and new symptoms after cysto-peritoneal shunting with a programmable valve, which reducing the pressure in the cyst resulted in remarkable resolution of her symptoms.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Nathan T
NT
Zwagerman
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jamie
J
Pardini
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Seyed H
SH
Mousavi
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Robert M
RM
Friedlander
Arachnoid cyst; cystoperitoneal shunt; optic nerve; seizures; tremor; valve-less shunt