Background: Until recently, the coexistence of arachnoid cysts in the brain with psychiatric disturbances had not been closely covered in the literature. However, there are some references that focus on a possible link between arachnoid cysts and psychotic symptoms. The purpose of this case report is to suggest a relationship between such lesions and psychiatric illness. This is an effort to bring the possibility of association of arachnoid cyst in a patient presenting with psychotic signs and symptoms to a mental health physician.
Case presentation: Arachnoid cysts are considered a rare neurological tumor, few of which exhibit any symptomatology. This is a case report of a 23-year-old North Indian male with no previous psychiatric history that presented with abrupt onset of psychosis. The workup for medical etiology was within normal limits, but on a brain scan there was well defined arachnoid cyst in the occipital region. The patient best responded to the second generation antipsychotic risperidone.
Conclusion: Clinically the association of psychotic features with the rare structural lesion in the brain is significant because many psychiatric cases go misdiagnosed and untreated if there is a concealed neurological or organic cause. Such cases often go reported as treatment refractory because our eyes see what our mind thinks. It’s rare to find association of arachnoid cyst with the psychiatric condition but keeping this as a possibility in mind can be rewarding.
