Visual attention in patients with intracranial arachnoid cysts

Objective. To investigate whether intracranial arachnoid cysts (AC) compromise visual attention and if so, whether surgical cyst decompression leads to improvement in visual attention performance. Methods.The experiments were carried out on 27 patients with temporal (n = 21) or frontal (n = 6) AC, and 27 healthy control subjects. All subjects were tested with two different visual attention paradigms. Patients were tested one day before and a minimum of 3 months after the surgery, with the same test-retest interval for the controls. Results. AC impair both automatic and effortful attention. These attention impairments were significantly improved after surgery, also when controlling for learning and practice effects from pre- to post-surgery testing. Closer analysis showed that these effects were carried by patients with right hemisphere cysts for impairment in shift of attention, and by patients with a left hemisphere cyst for visual search. Conclusions. AC may impair visual attention. Cyst location may be of importance for the development of these attention deficits, as there were significant differences between patients with right hemisphere cysts and those with left hemisphere cysts. This dyscognition appears to be reversible following surgical decompression. Surgical decompression of AC may thus relieve not only clinical symptoms and complaints, but cognitive impairments as well.