Intracranial arachnoid cyst: an institutional experience

Open access


Aim: In this study, symptoms at presentation, indication for surgery, surgical treatment modalities, postoperative results and complications were studied.

Material and methods: We retrospectively compiled the details of patients with IAC from admission and operative records admitted through our OPD during the period between January 1995 and January 2015. Only those patients were admitted whose symptoms attributes to the cyst and asymptomatic patients were followed on OPD basis. This is a single institutional study.

Results: This study includes 56 patients of IAC who were operated. Posterior fossa cysts (62.5%) were found more commonly symptomatic. Headache (32%) was the most common symptom in a patient with IAC. Out of all, 24 patients presented with headache and underwent surgery subsequently; 20 showed satisfactory relief after surgery while four showed partial relief. Size of cyst was significantly reduced after surgery in 52 patients after 12 weeks but four patients, who underwent cystoperitoneal shunt, required re-operation as patients showed no decrease in size of cyst due to shunt malfunction. Head circumference was reduced following intervention in infant patients. Three patients who presented with visual field defects with IAC in sellar region showed improvement after endoscopic fenestration of cyst. One of the patient with cerebellopontine angle arachnoid was died immediately after marsupialization due to unexplained bleeding.

Conclusions: IAC is not an uncommon finding on imaging but only few are symptomatic. Patients with Intracranial arachnoid cyst should be treated only if the patient’s symptoms are attributable to the cyst.

1. Al Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 5 :578 85, 2010

2. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg 118:222-31, 2013

3. Bilginer B, Onal MB, Oguz KK, Akalan N: Arachnoid cyst associated with subdural hematoma: report of three cases and review of the literature. Childs Nerv Syst 25:119–124, 2009

4. Boutarbouch M, El Ouahabi A, Rifi L, Arkha Y, Derraz S, El Khamlichi A: Management of intracranial arachnoid cysts: institutional experience with initial 32 cases and review of the literature. Clin Neurol Neurosurg 110:1–7, 2008

5. Domenicucci M, Russo N, Giugni E, Pierallini A: Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: neuroradiological evidence and surgical treatment. Clinical article. J Neurosurg 110:1250–1255, 2009

6. Eskandary H, Sabba M, Khajehpour F, Eskandari M: Incidental findings in brain computed tomography scans of 3000 head trauma patients. Surg Neurol 63(6):550-3, 2005

7. Go KG, Houthoff HJ, Blaauw EH, Havinga P, Hartsuiker J: Arachnoid cysts of the sylvian fissure. Evidence of fluid secretion. J Neurosurg 60:803–813, 1984

8. Harsh GR IV, Edwards MS, Wilson CB: Intracranial arachnoid cysts in children. J Neurosurg 64:835–842, 1986

9. Hellwig D, Schulte M, Tirakotai W. Surgical management of arachnoid, suprasellar, and Rathke’s cleft cysts. In: Schmidek HH, Roberts DW, editors. Schmidek and Sweet Operative Neurosurgical Techniques. 5th ed., vol. 1. Philadelphia: Saunders Elsevier; 2006. p. 455 76.

10. Johnson RD, Chapman S, Bojanic S: Endoscopic fenestration of middle cranial fossa arachnoid cysts: does size matter? J Clin Neurosci 18:607–612, 2011

11. Kandasamy J, Souweidane M. Editorial: Arachnoid cysts. J Neurosurg Pediatr 9:228‑30, 2012

12. Kang JK, Lee KS, Lee IW, Jeun SS, Son BC, Jung CK, et al: Shunt-independent surgical treatment of middle cranial fossa arachnoid cysts in children. Childs Nerv Syst 16:111–116, 2000

13. Katzman GL, Dagher AP, Patronas NJ: Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 282:36–39, 1999

14. Lee JY, Kim JW, Phi JH, Kim SK, Cho BK, Wang KC. Enlarging arachnoid cyst: A false alarm in infants. Childs Nerv Syst 28:1203 11, 2012

15. Levy ML, Wang M, Aryan HE, Yoo K, Meltzer H: Microsurgical keyhole approach for middle fossa arachnoid cyst fenestration. Neurosurgery 53:1138–1145, 2003

16. Marin-Sanabria EA, Yamamoto H, Nagashima T, Kohmura E: Evaluation of the management of arachnoid cyst of the posterior fossa in pediatric population: experience over 27 years. Childs Nerv Syst 23(5):535-42, 2007

17. Martínez-Lage JF, Ruíz-Espejo AM, Almagro MJ, Alfaro R, Felipe-Murcia M, López-Guerrero AL: CSF overdrainage in shunted intracranial arachnoid cysts: a series and review. Childs Nerv Syst 25:1061–1069, 2009

18. Oertel JM, Wagner W, Mondorf Y, Baldauf J, Schroeder HW, Gaab MR. Endoscopic treatment of arachnoid cysts: A detailed account of surgical techniques and results. Neurosurgery 67:824 36, 2010

19. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K: Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery 40:483–490, 1997

20. Shim KW, Lee YH, Park EK, Park YS, Choi JU, Kim DS: Treatment option for arachnoid cysts. Childs Nerv Syst 25 : 1459–1466, 2009

21. Spacca B, Kandasamy J, Mallucci CL, Genitori L: Endoscopic treatment of middle fossa arachnoid cysts: a series of 40 patients treated endoscopically in two centres. Childs Nerv Syst 26:163–172, 2010

Romanian Neurosurgery

The Journal of Romanian Society of Neurosurgery

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 311 233 26
PDF Downloads 107 86 14