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Do arachnoid cysts grow? A retrospective volumetric study.

Sven Kühn1, Sven-Erik Sönksen2, Frank Jakobs3

  • 1Department of Radiology, Central Military Hospital Koblenz, 56072, Koblenz, Germany.

Journal of Neurology
|March 28, 2021
PubMed
Summary

Most arachnoid cysts (ACs) do not grow and remain stable in size or shrink over time. Only larger, specific types of ACs, like Galassi II cysts, showed minimal growth in this study.

Keywords:
Arachnoid cystIncidental findingMiddle cranial fossaTemporal lobe

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Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Arachnoid cysts (ACs) are common incidental findings on cranial MRI.
  • ACs are often presumed to cause symptoms due to growth and pressure on brain tissue.

Purpose of the Study:

  • To investigate the growth patterns of arachnoid cysts over time.
  • To determine if ACs increase in size and which types are prone to growth.

Main Methods:

  • Retrospective analysis of a large database of cranial MRI scans.
  • Inclusion of 166 arachnoid cysts from 50 individuals with a mean observation period of 2.5 years.

Main Results:

  • The majority of arachnoid cysts remained stable in size or decreased.
  • Only larger Galassi II arachnoid cysts at the temporal pole demonstrated statistically significant growth (0.3 ml/year).
  • All studied cysts were clinically silent, with no associated symptoms.

Conclusions:

  • Most arachnoid cysts do not grow and maintain their size or shrink.
  • The assumption that AC growth causes symptoms may not apply to the majority of cases.
  • This study provides Class III evidence supporting the stability of most ACs.