Clinical and diagnostic parallels between arachnoid cysts and concomitant diseases in general medical practice | Ukrainian Medical Journal

The article considers the current issues of diagnostic search in the comorbid course of arachnoid cysts, arterial hypertension and cephalgic syndrome in general medical practice. The problem of hyperdiagnosis is highlighted, when the symptoms of hypertension are mistakenly interpreted as manifestations of fluid dynamic disorders. Attention is focused on the importance of a differential approach: determining the genesis of headache and assessing the clinical significance of the cyst. An algorithm of doctor’s tactics is proposed, which allows avoiding unjustified hospitalizations and ensuring timely control of blood pressure while maintaining dynamic observation of neuroimaging changes. The role of modern imaging methods (MRI, CT) in monitoring the dynamics of cyst development and preventing possible complications is determined. Methods. A literature review was conducted in the electronic databases PubMed/MEDLINE, Embase for the period 2002–2026 using the following keywords: «arachnoid cyst», «arterial hypertension», «headache», «comorbidity». A relevant clinical case is described, which emphasizes the importance of distinguishing between fluid dynamic disorders and hypertensive disorders in this genesis. Results. Intracranial arachnoid cysts are a common incidental finding during brain neuroimaging. Most of them are associated with congenital pathology, their localization and size do not correlate with the severity of arterial hypertension or the intensity of headache. Detection of arachnoid cysts on MRI often becomes a source of additional anxiety, therefore it is important to distinguish between their symptomatic nature or the absence of a direct causal relationship between the cyst and the patient’s complaints. This emphasizes the role of the general practitioner in the depathologizing of incidental findings. Conclusions. It is critically important to distinguish between fluid dynamic disorders caused by an arachnoid cyst and symptoms of hypertension. An undifferentiated approach to the genesis of headache leads to misinterpretation of the arachnoid cyst as the main pathological factor, which entails unjustified polypharmacy and untimely correction of blood pressure. Identification of specific «red flags» (for example, progressive intracranial hypertension) is the only reason for changing tactics from conservative to neurosurgical.

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