International Journal of Clinical & Medical Images

Clinical Image: The case presented here was a 25-year-old man consulted our hospital with a tension-type headache. He had been having this problem for about one year. Also, he had been diagnosed with attention deficit hyperactivity disorder in childhood, and he was using methylphenidate - immediate release (MPH-IR) daily regularly. Firstly, we stopped the methylphenidate-IR for one month because of its side effects. However, his tension-type headache continued. Secondly, we referred the patient to MRI scanning. MRI of the brain revealed an arachnoid cyst, measuring 10.4 cm by 9.2 cm by 6.3 cm, with massive pressure effect on the right cerebral hemisphere (Figure 1). Lastly, etodolac has been prescribed to prevent headaches. One month later patients had no troubles with headaches. In summary, large arachnoid cist might be a cause of ADHD in childhood because of its mass effect on prefrontal cortex and can cause tension-type headaches with any other neurological complication.