Giant left parietal lobe arachnoid cyst presenting as early-onset dementia

Description

A 56-year-old woman with no significant medical history was brought for evaluation of difficulty with speaking for 1 month. Family reported patient having short-term and long-term memory impairment and gradual cognitive decline over a course of 2 years. Her mother had Alzheimer's dementia in her 60s and the patient attributed her symptoms to Alzheimer's and did not seek medical attention until she developed word finding difficulty. On neurological examination, she had expressive aphasia and scored 20 on Mini-mental state examination (MMSE). Laboratory work-up showed normal haemogram, metabolic panel, thyroid function tests, vitamin B12 and folic acid levels and a negative rapid plasma reagin (RPR) test. MRI showed a giant left cerebral hemisphere arachnoid cyst with 11 mm midline shift to the right (figure 1). She underwent stereotactic craniotomy with microsurgical excision of the arachnoid cyst. Postoperative hospital course was complicated by generalised tonic–clonic seizure, controlled with antiepileptic...

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