Expert: JM Starkman, MD - 8/10/2009

Question
I am a healthy 34 year old man with only an occasional sinus headache.  I learned from reviewing my medical records from a CT scan 7 1/2 years ago I have an arachnoid cyst of 4 cm in the left middle cranial fossa with associated hypoplasia of the left anteriortemporal lobe.  There is no hemorrage, midline shift, edema or hydrocephalus. temporal lobe.  The scan came about after I sustained a hard blow to the head while exercising.  Is there any risk with this and undergoing local or general anesthesia?  Is there anything I should let the doctor know and I also found out I have one healthy kidney, does that affect going under anesthesia?

Please note I was under general anesthesia when I was 19 for wisdom teeth and other than being groggy when I awoke, I was fine and walking within 10 minutes.  

Answer
There is no increased risk with the anesthetic given the information you've provided.  One kidney presents no problem at all, but I would personally not recommend using the inhalational anesthetic called 'Sevoflurane' as it gives off free fluoride ions which can be kidney toxic and potentially, tho' unlikely, damage your single kidney.  Most experienced neuroanesthesiologists would be quite adept and comfortable utilizing another anesthetic or technique with varying doses of another similar medication called isoflurane which does not have this problem and has been extensively used successfully for all types of brain operations.

Have a long private interview with the anesthesiologist prior to any planned surgery to get your concerns adequately addressed. If it were my brain I'd be sure the anesthesiologist who interviewed me was the same one providing the anesthetic. Oh, and this:

Get a couple of neurosurgical opinions prior to operating on an asyptomatic arachnoid cyst.