Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report

Introduction: Intracranial arachnoid cysts located in the brainstem are extremely rare. Neurological symptoms usually depend on the location of the cyst and present with varying degrees of motor deficit and cranial nerve palsy. Our case report describes the successful surgical treatment of an intrap...

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Main Authors: Andrey Rostislavovich Sitnikov, Rezida Maratovna Galimova, Dmitriy Konstantinovich Krekotin
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Interdisciplinary Neurosurgery
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214751925000064
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author Andrey Rostislavovich Sitnikov
Rezida Maratovna Galimova
Dmitriy Konstantinovich Krekotin
author_facet Andrey Rostislavovich Sitnikov
Rezida Maratovna Galimova
Dmitriy Konstantinovich Krekotin
author_sort Andrey Rostislavovich Sitnikov
collection DOAJ
description Introduction: Intracranial arachnoid cysts located in the brainstem are extremely rare. Neurological symptoms usually depend on the location of the cyst and present with varying degrees of motor deficit and cranial nerve palsy. Our case report describes the successful surgical treatment of an intraparenchymal brainstem arachnoid cyst followed by significant improvement of severe disabling contralateral tremor. Case presentation: A 34-year-old man was admitted to our clinic with a two-year history of progressive disabling right-sided tremor and muscle weakness. Neurological examination on admission showed moderate left-sided blepharoptosis, right-sided hemiparesis (MRC grade 4 strength) and severe right-sided kinetic and postural tremor. MRI showed a large multiseptal cystic lesion within the left cerebral peduncle and left part of the midbrain. The patient underwent surgical fenestration of the cyst via a left supracerebellar infratentorial approach in the semi-sitting position. The postoperative course was uneventful with significant reduction of tremor and hemiparesis on the second postoperative day. Follow-up MRI at 3 and 12 months showed reasonable reduction in the size of the cystic lesion and restoration of brainstem anatomy. The patient’s tremor decreased by 70 % according to the Tremor Research Group Essential Tremor Rating Scale (TETRAS scale). Conclusion: In cases of intraparenchymal cystic lesions presenting with neurological abnormalities, surgical exploration and fenestration of the lesion may be a safe treatment option with a good functional outcome.
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spelling doaj-art-1ca5b0d92ae54c9b9dc5ba3cd8365d5f2025-02-12T05:31:09ZengElsevierInterdisciplinary Neurosurgery2214-75192025-03-0139101994Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case reportAndrey Rostislavovich Sitnikov0Rezida Maratovna Galimova1Dmitriy Konstantinovich Krekotin2Department of Neurosurgery, Multidisciplinary Medical Centre of Federal Medical-Biological Agency 298655 Yalta, Sevastopolskoe highway 2, Russia; Corresponding author.Intelligent Neurosurgery Clinic 450059 Ufa, Zorge st., 17/4, RussiaIntelligent Neurosurgery Clinic 450059 Ufa, Zorge st., 17/4, RussiaIntroduction: Intracranial arachnoid cysts located in the brainstem are extremely rare. Neurological symptoms usually depend on the location of the cyst and present with varying degrees of motor deficit and cranial nerve palsy. Our case report describes the successful surgical treatment of an intraparenchymal brainstem arachnoid cyst followed by significant improvement of severe disabling contralateral tremor. Case presentation: A 34-year-old man was admitted to our clinic with a two-year history of progressive disabling right-sided tremor and muscle weakness. Neurological examination on admission showed moderate left-sided blepharoptosis, right-sided hemiparesis (MRC grade 4 strength) and severe right-sided kinetic and postural tremor. MRI showed a large multiseptal cystic lesion within the left cerebral peduncle and left part of the midbrain. The patient underwent surgical fenestration of the cyst via a left supracerebellar infratentorial approach in the semi-sitting position. The postoperative course was uneventful with significant reduction of tremor and hemiparesis on the second postoperative day. Follow-up MRI at 3 and 12 months showed reasonable reduction in the size of the cystic lesion and restoration of brainstem anatomy. The patient’s tremor decreased by 70 % according to the Tremor Research Group Essential Tremor Rating Scale (TETRAS scale). Conclusion: In cases of intraparenchymal cystic lesions presenting with neurological abnormalities, surgical exploration and fenestration of the lesion may be a safe treatment option with a good functional outcome.http://www.sciencedirect.com/science/article/pii/S2214751925000064TremorBrainstemArachnoid cyst
spellingShingle Andrey Rostislavovich Sitnikov
Rezida Maratovna Galimova
Dmitriy Konstantinovich Krekotin
Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
Interdisciplinary Neurosurgery
Tremor
Brainstem
Arachnoid cyst
title Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
title_full Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
title_fullStr Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
title_full_unstemmed Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
title_short Resolution of tremor associated with brainstem arachnoid cyst following surgical intervention: A case report
title_sort resolution of tremor associated with brainstem arachnoid cyst following surgical intervention a case report
topic Tremor
Brainstem
Arachnoid cyst
url http://www.sciencedirect.com/science/article/pii/S2214751925000064
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AT rezidamaratovnagalimova resolutionoftremorassociatedwithbrainstemarachnoidcystfollowingsurgicalinterventionacasereport
AT dmitriykonstantinovichkrekotin resolutionoftremorassociatedwithbrainstemarachnoidcystfollowingsurgicalinterventionacasereport