A Bipolar Disorder Patient with Arachnoid Cysts: A Case Report

Abstract

Arachnoid cysts are cystic brain masses, filled with a liquid similar to cerebrospinal fluid. They generally do notshow clinical presentation and they are incidentallydetected during routine radiological evaluations.Although generally congenital, they can also develop following a trauma, a haemorrhage or an infection. Theyconstitute approximately 1% of all brain tumours. Ingeneral, these masses are located on midbrain. Eventhough their clinical presentation depends on their localization and their size, arachnoid cysts are generallyasymptomatic. Epileptic seizures, headache, discomfortdue to the increase in intracranial pressure are amongsymptoms of these masses. In addition, conditions suchas some endocrine disorders, optic neuritis, hydrocephalus can be cited among reasons by which patientsapply to a medical institution. Psychiatric disorderswhich ocur because of the arachnoid cysts are rare butthere are case reports depicted in the literature. In agreat majority of the case reports, the co-ocurrence ofarachnoid cysts and psychosis are brought up.Symptoms and signs most encountered in these casesare mentioned such as visual hallucinations, talking withunreal creatures, nervousness, irritability, persecutoryway of thinking, suspiciousness and motor excitation. Aswe investigated case reports already published, we stated that two group of researchers put forth the accompaniment of bipolar disorder and arachnoid cysts. In thepresent case report, we report a patient with the diagnosis of bipolar disorder and, arachnoid cysts in the righttemporal lobe and left sylvian fissure.

Özet

Araknoid kistler ço?unlukla klinik bulgu göstermeyen,radyolojik ara?tyrmalar syrasynda rastlantysal olarak saptanan ve içi beyin omurilik syvysyna benzer syvyyla dolu,kistik beyin kitleleridirler. Ço?unlukla konjenital olarakolu?an kitleler travma, kanama veya enfeksiyonlardansonra da geli?ebilirler. Bütün beyin kitlelerinin yakla?yk%1'ini olu?tururlar. En syk beyin orta hatta yerle?im gösterirler. Klinik yansymalary yerle?tikleri bölge ve büyüklüklerine göre de?i?mekle birlikte, ço?u kitle semptom vermez. Syk görülen belirtileri arasynda, epileptik nöbet, ba?a?rysy, kafa içi basynç arty?yna ba?ly bulgular bulunmaktadyr. Ayryca, endokrin bozukluklar, optik nörit, hidrosefali gibi durumlar da hastalaryn hekime ba?vuru nedenleriarasynda yer almaktadyr. Araknoid kistlere ba?ly geli?enpsikiyatrik hastalyklar az sayyda olmakla birlikte literatürde bildirilen vaka örnekleri bulunmaktadyr. Bildirilenvakalaryn önemli bir ço?unlu?unda, araknoid kist vepsikoz birlikteli?inden bahsedilmektedir, bu olgularda ensyk görülen semptomlar, gerçekte olmayan varlyklargörme, bu görüntülerle konu?ma, sinirlilik, iritabilite,dü?manca dü?ünceler besleme, ?üphecilik ve hareketlilikte arty? olarak bildirilmi?tir. Literatürdeki yayynlarabakyldy?ynda iki tane bipolar bozukluk ve araknoid kistbirlikteli?i olan olgu payla?ylmy? oldu?u görülmektedir.Sundu?umuz olgu bildiriminde, bipolar bozukluk tanysyalan, sa? temporal lobunda ve sol silvian fissüründe araknoid kistleri olan bir hasta tarty?ylmy?tyr.