Bahadır DEMİR, İhsan AKSOY, Gökay ALPAK, Ahmet ÜNAL, Haluk SAVAŞ, FERİDUN BÜLBÜL

Electroconvulsive Therapy in A Major Depression Patient with Arachnoid Cyst

Araknoid kist, erken fetal yaşamda araknoid membranın iki tabakasının birleşiminin gerçekleşmemesi sonucu oluşur ve bunu beyin omurilik sıvısı birikimi, kist oluşumu izler. Araknoid kistler kafa içi yer kaplayan lezyonların %1'ini oluşturur. Tanı, genelde genel tıbbi incelemeler sırasında konur. Epilepsi, artmış intrakranial basınç, nörolojik defisit, çocuklarda makrokranium ve gelişme geriliği, subdural hematomlara neden olabilirler. İntrakraniyal yer kaplayan lezyonların varlığında elektrokovülsif tedavi (EKT) uygulanırken dikkatli olunması tavsiye edilmektedir. EKT kafa içi basıncını artırarak, araknoid kisti olan hastalarda yan etkilerin oluşmasına neden olabilmektedir. Rüptüre olan araknoid kist, subdural efüzyon, subdural kanama ya da intrakistik kanama ile semptomatik hale gelebilir. Sunmakta olduğumuz bu olguya majör depresyon ve araknoid kist tanısı kondu. Medikal tedaviye yanıt vermeyen ve intihar düşüncesi olan hastaya EKT uygulandı. EKT ile hastanın şikayetleri tamamen düzeldi. Araknoid kistin boyutlarında herhangi bir büyüme veya komplikasyon görülmedi. Bu olguda, araknoid kist ile beraber EKT'nin başarılı bir şekilde uygulanması tartışıldı

Araknoid kisti olan majör depresyon vakasında elektrokonvülsif tedavi uygulaması

Arachnoid cyst develops when two layers of arachnoid membrane fail to unite in early fetal life causing cerebrospinal fluid accumulation and formation of a cyst. Arachnoid cysts constitute 1% of space occupying lesions in the brain. Diagnosis is made usually with regular medical examinations. They can cause epilepsy, increased intracranial pressure, neurological deficits, macrocranium and growth deficit in children, and subdural hematoma. It has been recommended to be careful when administrating Electroconvulsive therapy (ECT) to the patients with space occupying lesions. ECT can cause adverse effects in patients with arachnoid cyst by increasing intracranial pressure. Arachnoid cyst can rupture and give symptoms by causing subdural effusion, subdural hemorrhage or intracystic hemorrhage. In this case, we diagnosed major depression and arachnoid cyst. We administered ECT to the patient who had suicide ideation and was resistant to pharmacotherapy. Patient’s complaints fully recovered with ECT. The size of arachnoid cyst didn’t increase and we observed no complication. In this case, we aimed to show that ECT could be successfully administered to the patients with arachnoid cyst

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