Intracranial arachnoid cysts: current concepts and treatment alternatives

Arachnoid cysts are non-tumorous intra-arachnoid fluid collections that account for about 1% of all intracranial space-occupying lesions. In this article, we review the current concepts about these lesions and discuss the treatment alternatives. The aetiology of arachnoid cysts has been a controversial subject. They are regarded as developmental abnormality of the arachnoid, originating from a splitting or duplication of this membrane. The establishment of a single CSF space, by surgically communicating the cyst with the ventricular system or basal cisterns, appears to offer the best chance of a success in the treatment of arachnoid cysts. Long-term prognosis for patients with arachnoid cysts and well-preserved neurological conditions is good, even in the case of subtotal excision. Clinical follow-up and MRI allow earlier diagnosis of recurrence.