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Arachnoid cyst and psychosis in an adolescent

Published online by Cambridge University Press:  16 April 2020

M. Graovac
Affiliation:
University Psychiatric Clinic, Department of Adolescent Psychiatry
K. Ružić
Affiliation:
University Psychiatric Clinic, Department of Social Psychiatry, University Hospital Centre Rijeka, School of Medicine Rijeka
H. Sveško Visentin
Affiliation:
University Psychiatric Clinic, Department of Psychology, University Hospital Rijeka
T. Grahovac
Affiliation:
University Psychiatric Clinic, University Hospital Centre Rijeka, School of Medicine Rijeka
E. Dadić Hero
Affiliation:
Department of Social Medicine and Epidemiology, School of Medicine, University of Rijeka
J. Rebić
Affiliation:
University Psychiatric Clinic, University Hospital Rijeka
T. Frančišković
Affiliation:
University Psychiatric Clinic, Department of Psychological Medicinedolescent Psychiatry, University Hospital Centre Rijeka; Faculty of Medicine, Department of Psychiatry and Psychological Medicine, Rijeka, Croatia
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Abstract

Introduction

Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF). They are often discovered as incidental findings found on imaging. Occasionally they may produce symptoms because of expansion or bleeding.

Objectives

The coexistence of arachnoid cysts with psychiatric disturbances in adolescents had not been closely covered in the literature. Recent descriptions of aphasia and attention-deficit disorders associated with these cysts indicate that we do not fully understand this entity. There is also no acceptable explanation for the male preponderance and increased incidence on the left side.

Aims

The appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms in adolescents has increased the interest in this subject.

Methods and results

This case report describes the treatment of a 17-year old male adolescent, characterized by “negative” psychotic symptoms, reduced affect, unfunctioning behavior, headaches and vision problems. An arachnoid cyst was found on the temporobasilaris left brain side on magnetic resonance image. His psychotic symptoms were suspected to be induced by the arachnoid cyst. The patient was treated with an outpatient antipsychotic therapy (olanzapin) during one year and shown improvement, but without a complete remission of the psychotic symptoms.

Conclusions

It is difficult to discus whether the lesion had influence on the patient’s psychiatric symptoms or not, but clinical features and treatment modalities points this possibility. However, the co morbidity of neurological and psychiatric symptoms in adolescence raises problems when it comes to choosing the therapeutic guidelines.

Type
P01-291
Copyright
Copyright © European Psychiatric Association 2011

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