Intracranial arachnoid cysts

Purpose The purpose of this review article is to outline the natural history, pathogenesis, anatomic considerations and surgical decision-making in caring for patients with intracranial arachnoid cysts. Methods A review of the literature for intracranial arachnoid cysts was performed using Embase, PubMed, and Web of Science databases, including review of the bibliographies of eligible articles and the author's own experience. Results Among those reviewed, 59 relevant original articles were included as well as illustrative cases from the authors own experience. Conclusions Arachnoid cysts are congenital lesions characterized by split arachnoid membrane, thick collagen in the cyst wall, absent traversing trabecular processes within the cyst, and hyperplastic arachnoid cells in the cyst wall. The underlying etiology is not entirely known, and they occur in greater proportion in males and in greater incidence with various genetic conditions including Down syndrome, mucopolysaccharidosis, schizencephaly, neurofibromatosis, autosomal dominant polycystic kidney disease (ADPKD), acrocallosal syndrome, and Aicardi syndrome. Most intracranial arachnoid cysts are incidentally found and occur in the middle cranial fossa, with the remaining occurring in the cerebellopontine angle, suprasellar cistern, quadrigeminal cistern, convexity, and posterior fossa/cisterna magna. The current article outlines the natural history, prevalence, demographic factors, and treatment decisions in managing patients with intracranial arachnoid cysts.

Automated summary

The purpose of this review article is to outline the natural history, pathogenesis, anatomic considerations, and surgical decision-making in caring for patients with intracranial arachnoid cysts. A comprehensive review of relevant articles and the author's own experience was conducted. Arachnoid cysts are congenital lesions characterized by specific features. The underlying etiology is not entirely known, and they are associated with various genetic conditions. Most intracranial arachnoid cysts are incidentally found, primarily in the middle cranial fossa. This article provides a comprehensive overview of the management of patients with intracranial arachnoid cysts.