合併蜘蛛膜囊腫與憂鬱症狀病人之另一種探討

An Unusual Approach to a Patient with an Arachnoid Cyst and Depression

目的：蜘蛛膜囊腫是最常見的顱內囊腫，它們對精神症狀的影響經常被低估。本文報告一合併憂鬱症狀及顱內蜘蛛膜囊腫之個案。病例報告：一位53歲女性，她表現未註明的憂鬱症狀，腦部核磁共振發現在右側顳極有一個約3公分大小的蜘蛛膜囊腫。在使用duloxetine下臨床反應極佳，但語言智商與操作智商的不一致則持續存在。結論：這是第一篇關於蜘蛛膜囊腫合併憂鬱的報告，也彰顯不同的探討方式在處理合併腦部病變與精神症狀之病人上的效用。

Objective: Arachnoid cysts are the most common intracranial cysts and their role in causing psychiatric symptoms is often underrecognized. This report is a case of a patient with intracranial arachnoid cyst and clinical fi nding of depression. Case report: A 53-year-old woman patient presented with unspecifi ed depressive symptoms and the brain MRI fi nding showed an arachnoid cyst about 3 cm in size over the right temporal pole. She showed dramatic clinical response to duloxetine but the discrepancy between her verbal IQ and performance IQ were still persisted. Conclusion: This case report is the fi rst to show an association between arachnoid cysts and clinical depression, and to highlight the use of an unusual approach in dealing with a patient with brain lesions and psychiatric symptoms.