Doctor: Cysts like Meyer's can be troublesome
Dr. James Uselman has treated patients with arachnoid cysts for about 25 years.
As an OhioHealth neurosurgeon operating from Riverside Methodist Hospital, Uselman estimates that he sees 20 to 30 people per year with such cysts, which develop around the surface of the brain. Ohio State coach Urban Meyer is not one of his patients, and Uselman stressed that he does not know the specifics of his case.
Meyer revealed to several reporters, including those from The Dispatch, that he is suffering severe headaches from his cyst. Though he hopes to continue coaching, the pain from them could preclude that.
Arachnoid cysts are fluid-filled sacs, Uselman said. They are not tumors and aren’t malignant. Uselman said most people with an arachnoid cyst aren’t aware they have one unless detected by a test such as an MRI or CT scan. He said 90 percent of people with arachnoid cysts have no symptoms and require nothing more than to be monitored.
But an arachnoid cyst can cause problems when its size or location causes it to press against the brain, as Meyer’s does.
“Depending on where the cyst is, it could make you weak, can make you numb,” Uselman said. “You could have seizures from it.”
Uselman said that in severe cases, one of two operations usually is performed. The first is to make small holes into the cyst so liquid from it can be drained. That is believed to be the type of operation Meyer had in the spring of 2014.
“The other alternative — and if it’s deep within the brain, this may be the more attractive alternative — would be to put a shunt in,” Uselman said. “A shunt is a tube where you put a little hole in the skull. You can pass that tube into the cyst and can drain that fluid.”
He explained that the shunt has a one-way valve to prevent fluid from going back into the brain. The other end of the shunt goes to another part of the body, often the abdomen.
Like any surgery, there are risks of complications, Uselman said.
“I tell my patients, ‘Any operation on me is a serious operation,’ ” he said. “A shunt, as far as the actual tissue damage, is a relatively minor procedure. But I would never call a procedure on the brain minor because you do have to pass that catheter through some brain tissue to get into the cyst.”
The odds of a serious complication are small, Uselman said. The recovery time for such a procedure is usually 2 to 3 weeks. Asked whether patients can recover fully from it, he said, “Absolutely.”
“I tell all my patients there are literally hundreds of thousands of people in the country walking around with shunts, that you have no idea have shunts, who live perfectly normal lives.”