Abstract
Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid (CSF)-filled spaces lined with arachnoid membranes. Large arachnoid cysts are often symptomatic because they compress surrounding structures; therefore, they must be treated surgically. As several surgical management options exist, we explore the best approach according to each major type of arachnoid cyst: middle cranial fossa cyst, suprasellar cyst, intrahemispheric cyst, and quadrigeminal cyst.
Highlights
BackgroundArachnoid cysts can be classified as primary developmental cysts or secondary cysts
Primary cysts arise from the splitting of the arachnoid membranes in utero, resulting in the development of anomalous collections of cerebrospinal fluid (CSF)
The endoscopic management of intracranial arachnoid cysts is a safe and effective therapeutic modality that results in a high success rate
Summary
Arachnoid cysts can be classified as primary developmental cysts or secondary cysts. Primary cysts arise from the splitting of the arachnoid membranes in utero, resulting in the development of anomalous collections of cerebrospinal fluid (CSF). A recent meta-analysis concluded that while all three surgical methods (endoscopic, microsurgical, and shunting) are effective for the management of middle fossa cysts, endoscopic fenestration is the preferred primary surgical modality The latter two options should only be considered when symptoms are unchanged after endoscopic treatment [19]. Cinalli et al concluded that arachnoid cysts of the quadrigeminal cistern can be effectively treated by endoscopy, with a success rate of 90% observed in the series if endoscopy was the first line of treatment. They stated that endoscopic third ventriculostomy should be combined with ventriculocystostomy to offer the highest success rate with a single procedure [26]
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