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J Neurol Neurosurg Psychiatry. 1995 September; 59(3): 293–298.
PMCID: PMC486033

Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement.


Thirteen adult patients were operated on for symptomatic arachnoid cysts in the left temporal fossa; seven with an internal shunt procedure during local anaesthesia, and five with a craniotomy with fenestration of the cyst to the basal cisterns. In one patient, an initial internal shunt was transformed to a cystoperitoneal shunt. After surgery, all patients experienced relief of symptoms. Reduction of cyst volume occurred in 11 patients. The patients were tested for brain asymmetries related to language and verbal memory before and after operation, with a dichotic listening technique with simultaneous presentation of different auditory stimuli to the two ears. In the preoperative memory test, the patients showed impaired total recall compared with healthy control subjects, and recall from the right ear was significantly impaired. The patients also performed poorly in a forced attention task consisting of dichotic presentations of consonant-vowel syllables. In addition to clinical improvement, the surgical procedures led to improvements in both dichotic perception and memory. Overall memory performance was enhanced, mainly because of improved recall from the right ear. This normalisation of memory function was found as early as four hours after the operation. The results indicate that arachnoid cysts in the left temporal fossa may impair cognitive function, that neuropsychological tests are necessary to disclose these impairments, and that cognitive improvement occurs after surgery.

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  • STARKMAN SP, BROWN TC, LINELL EA. Cerebral arachnoid cysts. J Neuropathol Exp Neurol. 1958 Jul;17(3):484–500. [PubMed]
  • Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol. 1981 Jan;40(1):61–83. [PubMed]
  • Geissinger JD, Kohler WC, Robinson BW, Davis FM. Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol. 1978 Jul;10(1):27–33. [PubMed]
  • Kumagai M, Sakai N, Yamada H, Shinoda J, Nakashima T, Iwama T, Ando T. Postnatal development and enlargement of primary middle cranial fossa arachnoid cyst recognized on repeat CT scans. Childs Nerv Syst. 1986;2(4):211–215. [PubMed]
  • Beltramello A, Mazza C. Spontaneous disappearance of a large middle fossa arachnoid cyst. Surg Neurol. 1985 Aug;24(2):181–183. [PubMed]
  • Inoue T, Matsushima T, Tashima S, Fukui M, Hasuo K. Spontaneous disappearance of a middle fossa arachnoid cyst associated with subdural hematoma. Surg Neurol. 1987 Dec;28(6):447–450. [PubMed]
  • Becker T, Wagner M, Hofmann E, Warmuth-Metz M, Nadjmi M. Do arachnoid cysts grow? A retrospective CT volumetric study. Neuroradiology. 1991;33(4):341–345. [PubMed]
  • Mayr U, Aichner F, Bauer G, Mohsenipour I, Pallua A. Supratentorial extracerebral cysts of the middle cranial fossa. A report of 23 consecutive cases of the so-called temporal lobe agenesis syndrome. Neurochirurgia (Stuttg) 1982 Mar;25(2):51–56. [PubMed]
  • Cilluffo JM, Onofrio BM, Miller RH. The diagnosis and surgical treatment of intracranial arachnoid cysts. Acta Neurochir (Wien) 1983;67(3-4):215–229. [PubMed]
  • Gandy SE, Heier LA. Clinical and magnetic resonance features of primary intracranial arachnoid cysts. Ann Neurol. 1987 Apr;21(4):342–348. [PubMed]
  • Kunz U, Rückert N, Tägert J, Dietz H. Clinical and neuropsychological results after operative and conservative treatment of arachnoidal cysts of the perisylvian region. Acta Neurochir Suppl (Wien) 1988;42:216–220. [PubMed]
  • Dei-Anang K, Voth D. Cerebral arachnoid cyst: a lesion of the child's brain. Neurosurg Rev. 1989;12(1):59–62. [PubMed]
  • Robertson SJ, Wolpert SM, Runge VM. MR imaging of middle cranial fossa arachnoid cysts: temporal lobe agenesis syndrome revisited. AJNR Am J Neuroradiol. 1989 Sep-Oct;10(5):1007–1010. [PubMed]
  • Aicardi J, Bauman F. Supratentorial extracerebral cysts in infants and children. J Neurol Neurosurg Psychiatry. 1975 Jan;38(1):57–68. [PMC free article] [PubMed]
  • Choux M, Raybaud C, Pinsard N, Hassoun J, Gambarelli D. Intracranial supratentorial cysts in children excluding tumor and parasitic cysts. Childs Brain. 1978;4(1):15–32. [PubMed]
  • Lodrini S, Lasio G, Fornari M, Miglivacca F. Treatment of supratentorial primary arachnoid cysts. Acta Neurochir (Wien) 1985;76(3-4):105–110. [PubMed]
  • Marinov M, Undjian S, Wetzka P. An evaluation of the surgical treatment of intracranial arachnoid cysts in children. Childs Nerv Syst. 1989 Jun;5(3):177–183. [PubMed]
  • Lang W, Lang M, Kornhuber A, Gallwitz A, Kriebel J. Neuropsychological and neuroendocrinological disturbances associated with extracerebral cysts of the anterior and middle cranial fossa. Eur Arch Psychiatry Neurol Sci. 1985;235(1):38–41. [PubMed]
  • Gallassi R, Ciardulli C, Ferrara R, Lorusso S, Galassi E, Lugaresi E. Asymptomatic large arachnoid cyst of the middle cranial fossa. A clinical and neuropsychological study. Eur Neurol. 1985;24(2):140–144. [PubMed]
  • Wester K. Gender distribution and sidedness of middle fossa arachnoid cysts: a review of cases diagnosed with computed imaging. Neurosurgery. 1992 Nov;31(5):940–944. [PubMed]
  • Ojemann GA. Enhancement of memory with human ventrolateral thalamic stimulation: effect evident on a dichotic listening task. Appl Neurophysiol. 1985;48(1-6):212–215. [PubMed]
  • Hugdahl K, Wester K, Asbjørnsen A. The role of the left and right thalamus in language asymmetry: dichotic listening in Parkinson patients undergoing stereotactic thalamotomy. Brain Lang. 1990 Jul;39(1):1–13. [PubMed]
  • Hugdahl K, Wester K, Asbjørnsen A. Dichotic listening in an aphasic male patient after a subcortical hemorrhage in the left fronto-parietal region. Int J Neurosci. 1990 Sep;54(1-2):139–146. [PubMed]
  • Christianson SA, Nilsson LG, Silfvenius H. Initial memory deficits and subsequent recovery in two cases of head trauma. Scand J Psychol. 1987;28(4):267–280. [PubMed]
  • Raczkowski D, Kalat JW, Nebes R. Reliability and validity of some handedness questionnaire items. Neuropsychologia. 1974 Jan;12(1):43–47. [PubMed]
  • Hugdahl K, Andersson L. The "forced-attention paradigm" in dichotic listening to CV-syllables: a comparison between adults and children. Cortex. 1986 Sep;22(3):417–432. [PubMed]
  • KIMURA D. Some effects of temporal-lobe damage on auditory perception. Can J Psychol. 1961 Sep;15:156–165. [PubMed]
  • Hugdahl K, Wester K. Dichotic listening studies of hemispheric asymmetry in brain damaged patients. Int J Neurosci. 1992 Mar;63(1-2):17–29. [PubMed]
  • Hugdahl K, Wester K, Asbjørnsen A. Auditory neglect after right frontal lobe and right pulvinar thalamic lesions. Brain Lang. 1991 Oct;41(3):465–473. [PubMed]
  • Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, Frank G. CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol. 1982 May;17(5):363–369. [PubMed]

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