This is 45 year old male with schizophrenia and reveals prominent anterior temporal CSF space which may indicate arachnoid cyst along with asymmetric atrophy of the temporal lobes. It is difficult to tell whether the lesion was innocent or not regarding this patient's overall psychiatric picture. Although, literature review has revealed some cases of arachnoid cyst associated with psychosis.
" Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF). In most cases they are diagnosed by accident. Until recently, the coexistence of arachnoid cysts with psychiatric disturbances had not been closely covered in the literature. However, the appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms has increased the interest in this subject and raised questions about the etiopathogeny and the therapeutic approach involved." [2]
"Studies have demonstrated various other structural abnormalities. Most studies do not find abnormalities of whole brain/intracranial contents, while lateral ventricle & third ventricle enlargement is frequently reported. The temporal lobe was the brain parenchymal region with the most consistently documented abnormalities. Volume decreases especially involving the superior temporal gyrus. About two thirds of the studies of subcortical structures of thalamus, corpus callosum and basal ganglia show positive findings, as do almost all studies of cavum septi pellucidi (CSP). " [1]
Reference --
- Biol Psychiatry. 1999 May 1;45(9):1099-119. MRI anatomy of schizophrenia.
- Arachnoid cyst in a patient with psychosis: Case report. Annals of General Psychiatry 2007, 6:16
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