Arachnoid cyst physical examination

Physical examination is generally not very useful as most cases of arachnoid cysts are diagnosed incidentally, but in larger cysts, depending of the affected region, there may be some findings.

• The majority of the arachnoid cysts are asymptomatic;
• Physical examination findings are more frequent in the large cysts and may be very diverse due to the fact that the symptoms often vary with the location;
• Some of the most prevalent physical examination are:
  • Ataxia;
  • Hearing loss;
  • Visual changes;^[1]
  • Protrusions from the head or spine;
  • Head bobbing;
  • Endocrine issues, e.g. early onset of puberty.^[2]
• There’s a case report from UCLA of a female patient who presented with altered mental status and speech abnormalities.^[3]
• Spinal meningeal cysts, a rare form of arachnoid cysts, usually present with progressive spastic or flaccid paraparesis or quadriparesis in the second decade of life. 10% may present with monoparesis.^[4]