Dear Dr. Joshua,

I am trying to find out if a brain cyst can be diagnosed and said to be benign if only a cat scan was done. I was told today that I have one and I am very concerned because no treatment or follow up or futher testing was discussed. I can find out how to post a question can you please help me. I am a 53 year old female who has had a horrible painful migraine since last wed January 2nd and it has been accompanied by vomiting. It is the worst migraine I have ever had. I spent friday and saturday in the er and that is where the cat scan was done. I need to know if it is possible to diagnose without seeing me or futher testing. And if it is benign cyst does anything need to be done and is this the cause of this massive migraine.

Dr. Joshua’s Answer:

Certain types of cysts can be reliably diagnosed with CT (Cat scan) alone, for instance, typical arachnoid cysts, which commonly occur in the temporal region. Often they require no treatment or follow up at all, and are usually congenital, in other words, something you’re born with. Sometimes arachnoid cysts build up pressure and cause symptoms, but more often than not they are an incidental finding.

Typically they are found when doing a CT due to headaches, but they rarely explain the headaches.

There are a variety of possible “cysts” that can be seen on CT, and if the finding is unclear, an MRI is usually done. Only your doctor can tell you what exactly it is they saw, and why they chose not to do any further investigations. Please call your doctor and ask him/her to explain the finding and its significance to you.

Good luck-

Dr. Joshua