Different Surgical Options for the Management of Intracranial Arachnoid Cysts

The aims of this study are to present our results and determine the most effective method on the surgical treatment of intracranial arachnoid cysts. The data of 44 patients who underwent surgical treatment for intracranial arachnoid cyst between 2011 and 2019 were retrospectively reviewed. Age, gender, location of the cyst, clinical presentation, surgical technique, and outcomes of patients were recorded and analyzed. The results were compared statistically. Among the 44 patients, 36 were male and 8 were female with a mean age of 19.77 years. Twelve patients were children and 32 were adults. Signs of increased intracranial pressure were observed in 35 patients and epilepsy in 9 patients. The most frequent locations were temporal, frontotemporal, and frontoparietal regions. Cyst fenestration was used in 34 patients while cystoperitoneal shunt + fenestration in 8 and only shunt in 2 patients. Subdural effusion was seen in 5 patients and wound dehiscence in 6 patients after surgery. Forty patients were improved after surgery while 4 patients remained symptomatic during the follow-up period. Cyst fenestration is the most effective treatment method for intracranial arachnoid cysts. It may be performed using either microscopic or endoscopic technique. Re-closure of the fenestration is the main problem especially when performed in young children.