Bilişsel Bozukluk ve Hipomani Belirtileriyle Başvuran Bir Araknoid Kist Olgusu

Bahadır GENİŞ, Behcet COŞAR
2020; 31(2): 131-136
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A Case of Arachnoid Cyst Presenting with Cognitive Impairment and Hypomania Symptoms

Arachnoid cysts are benign congenital malformations of the arachnoid
which account for approximately 1.4% of the intracranial lesions.
Although it is usually asymptomatic, it may be accompanied by
headache, hydrocephalus and seizure. Psychiatric disorders associated
with arachnoid cysts are rare. In this article, we present a giant arachnoid
cyst with hypomania symptoms and marked cognitive impairment. A
44-year-old female patient was admitted to our outpatient clinic with
a 4-year history of headache, nervousness and attention problems.
Magnetic resonance imaging revealed a giant arachnoid cyst with a size
of 5.5x10.5x12.5 cm was found in the left hemisphere of the patient.
Considering the patient’s irritability, increase in the amount of speech,
flight of ideas, sleep disturbance and attention disorders, the diagnosis
of hypomania was made. The neuropsychological tests showed that
the speed of information processing, mental flexibility and attention
functions decreased, and executive functions were impaired. The
patient was consulted to the neurosurgery department. But no surgical
treatment was offered. Drug therapy for hypomanic symptoms and
cognitive impairment was planned, but could not be started since the
patient did not attend to the follow-up exams. Albeit the lack of followup constitutes a limitation for our report, we believe that the size of the
cyst, significant impairment of cognitive functions and the presence of
hypomania symptoms might contribute significantly to the literature.
Other cases with arachnoid cyst displaying cognitive impairment were
summarized in our article.
Key Words: Bipolar disorder, arachnoid cyst, memory disorders, cognitive disorders, hypomania, affective symptoms