Korean J Radiol.  2013 Oct;14(5):829-831. 10.3348/kjr.2013.14.5.829.

Arachnoid Cyst in Oculomotor Cistern

• Kim MK
• Choi HS
• Jeun SS
• Jung SL
• Ahn KJ
• Kim BS

• KMID: 1711442
• DOI: http://doi.org/10.3348/kjr.2013.14.5.829

Abstract

Oculomotor cistern is normal anatomic structure that is like an arachnoid-lined cerebrospinal fluid-filled sleeve, containing oculomotor nerve. We report a case of arachnoid cyst in oculomotor cistern, manifesting as oculomotor nerve palsy. The oblique sagittal MRI, parallel to the oculomotor nerve, showed well-defined and enlarged subarachnoid spaces along the course of oculomotor nerve. Simple fenestration was done with immediate regression of symptom. When a disease develops in oculomotor cistern, precise evaluation with proper MRI sequence should be performed to rule out tumorous condition and prevent injury of the oculomotor nerve.

Keyword

Arachnoid cyst; Oculomotor nerve cistern; Oculomotor nerve

MeSH Terms

Adult
Arachnoid Cysts/*diagnosis/surgery
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Neurosurgical Procedures
Oculomotor Nerve/*pathology
Oculomotor Nerve Diseases/*diagnosis/surgery

Figure

• 

  Fig. 1 Findings of arachnoid cyst in oculomotor cistern on MR images and immunohistochemistry. A. Axial MR image with heavily T2-weighted 3D turbo spin-echo sequence shows hyperintense lesion as arachnoid cyst (straight arrow) with internal oculomotor nerve (curved arrow) in right orbital apex. B. Gadolinum-enhanced T1-weighted MR image in axial plane reveals no enhancement of lesion (arrow). C. Oblique sagittal MR image with heavily T2-weighted 3D turbo spin-echo sequence reveals oculomotor nerve within lesion (curved arrow) which comes from interpeduncular cistern, passes through oculomotor cistern (between arrowheads), and continued with cystic lesion (straight arrow) in orbital apex. D. Immunohistochemical staining of surgical specimen with 400 high-power fields showed positive for epithelial membrane antigen, which is suggestive of arachnoid cyst.

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