Experience with Management of Intracranial Arachnoid Cysts

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Cystic Lesions of the Brain

Background:

• Intracranial arachnoid cysts are common developmental abnormalities.
• Symptomatic arachnoid cysts require effective surgical management.

Purpose of the Study:

• To analyze demographics, clinical presentation, and surgical outcomes of intracranial arachnoid cysts.
• To review and compare surgical options for arachnoid cysts.

Main Methods:

• Retrospective observational study of 56 symptomatic arachnoid cyst cases (2004-2020).
• Interventions included endoscopic fenestration, microsurgical excision, and shunt insertion.
• Follow-up ranged from 1 month to 16 years; statistical analysis on 43 patients with ≥3 years follow-up.

Main Results:

• 75% of patients were under 18 years old, predominantly 1-10 years.
• Common cyst locations: temporal, retrocerebellar, quadrigeminal cistern.
• Headache and vomiting were the most frequent symptoms; 24 cases had hydrocephalus.
• Endoscopic fenestration (35 cases) showed significantly better post-operative cyst size reduction (p<0.05).

Conclusions:

• Surgery is beneficial for symptomatic intracranial arachnoid cysts.
• Endoscopic fenestration is the recommended first-line surgical approach.
• Shunt insertion may be necessary for very young children with associated hydrocephalus or macrocephaly.