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Objective: This study presents a case of a teenager (J.J.) prenatally diagnosed with large arachnoid cysts which did not allow parts of his brain to develop correctly. It aims to establish whether the congenital malformation affected the boy's cognitive development. Method: In order to assess his cognitive development, the authors analyzed J.J.'s medical history, interviewed him and his parents and conducted neuropsychological examination. Results: Despite major parts of his brain undeveloped, the boy achieved average to outstanding scores in all tests. Conclusions: The scores achieved by J.J. suggest that normal development of cognitive abilities is possible even for a person whose central nervous system differs structurally from what is expected in a healthy subject.

In this article, an account is given on the author's experience with auditory based neuropsychology in a clinical, neurosurgical setting. The patients that were included in the studies are patients with traumatic or vascular brain lesions, patients undergoing brain surgery to alleviate symptoms of Parkinson's disease, or patients harbouring an intracranial arachnoid cyst affecting the temporal or the frontal lobe. The aims of these investigations were to collect information about the location of cognitive processes in the human brain, or to disclose dyscognition in patients with an arachnoid cyst. All the patients were tested with the DL technique. In addition, the cyst patients were subjected to a number of non-auditory, standard neuropsychological tests, such as Benton Visual Retention Test, Street Gestalt Test, Stroop Test and Trails Test A and B. The neuropsychological tests revealed that arachnoid cysts in general cause dyscognition that also includes auditory processes, and more importantly, that these cognition deficits normalise after surgical removal of the cyst. These observations constitute strong evidence in favour of surgical decompression.

Arachnoid cysts (AC) are intracranial, extracerebral cysts. They can produce a wide variety of neurological symptoms, but they can also be asymptomatic or produce psychological or psychiatric symptoms. First, a short overview of the clinical manifestations of AC is given. There is an astonishing lack of literature dealing with psychological problems in children with AC. The case of a 12-year-old boy with a large left temporofrontal AC without increased intracranial pressure is presented. The psychiatric symptoms, which had begun only a few months earlier, included lack of interest, attention deficit, difficulties in contact and communication, severe outbursts of aggression and obsessive-compulsive, inhibited behavior. The main neuropsychological finding was slow and hesitant expression of thoughts despite an intelligence level in the upper normal range. The findings and course are described in detail. They are discussed as signs of an organic psychosyndrome due to the AC.