• William Clifton, Gazanfar Rahmathulla, Kourosh Tavanaiepour, Dunbar Alcindor, George Jakubek, and Daryoush Tavanaiepour.
• Department of Neurological Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA. Electronic address: clifton.william@mayo.edu.
• World Neurosurg. 2018 Aug 1; 116: 329-332.

BackgroundArachnoid cysts are a relatively common finding in adult patients, especially with the advent of advanced imaging techniques. The overall incidence ranges from 1%-2%, and the majority are clinically silent. Arachnoid cysts are postulated to arise by congenital anomalies or trauma. De novo formation of arachnoid cysts has been reported but is exceptionally rare and mostly found in the pediatric population after head trauma. There have only been 2 reported cases of symptomatic de novo arachnoid cyst formation in adult patients to date, both with histories of head trauma.Case DescriptionWe present a case of a 71-year-old male patient with progressive vertigo who had previous brain magnetic resonance imaging studies without abnormalities. Another MRI was performed 3 years from the last study that showed interval development of a large cystic lesion compressing the right cervicomedullary junction, as well as radiologic evidence of neurosarcoidosis. Intraoperative findings showed a cystic mass with clear, gelatinous fluid. The cyst was drained, and the walls were resected and sent to pathology. Histopathologic testing confirmed the lesion was an arachnoid cyst. The patient's vertiginous symptoms improved after surgery.ConclusionsThis case represents the first incidence of a pathology-proven, nontraumatic de novo arachnoid cyst.Copyright © 2018 Elsevier Inc. All rights reserved.

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