A Comprehensive Review of Arachnoid Cysts

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Arachnoid cysts are cerebrospinal fluid (CSF)-filled sacs within the arachnoid membrane.
• They can cause neurological symptoms due to mass effect or CSF flow obstruction.
• Optimal management strategies remain a subject of debate.

Purpose of the Study:

• To review the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of arachnoid cysts.
• To analyze current and future management directions for these cysts.
• To highlight advances in diagnostic and therapeutic approaches.

Main Methods:

• Comprehensive literature review of arachnoid cysts.
• Analysis of diagnostic modalities, including Magnetic Resonance Imaging (MRI).
• Evaluation of various surgical and conservative treatment strategies.

Main Results:

• Prevalence is approximately 1-2%, with a male predominance, commonly found in the Sylvian fissure and posterior fossa.
• MRI is the gold standard for diagnosis; diffusion-weighted and cine phase-contrast MRI assess CSF dynamics.
• Conservative management for asymptomatic cases; surgical intervention for symptomatic cases (hydrocephalus, seizures, deficits).

Conclusions:

• Asymptomatic arachnoid cysts typically warrant conservative management with follow-up.
• Symptomatic cysts require intervention, with endoscopic fenestration being a less invasive option with higher recurrence rates.
• Future directions include AI-driven modeling, robotic surgery, and personalized protocols to optimize outcomes.