From the Research
The treatment for symptomatic arachnoid cysts primarily involves surgical intervention, with endoscopic fenestration being a preferred approach due to its effectiveness and lower risk of complications, as supported by recent studies 1, 2. The main surgical options include craniotomy for fenestration, endoscopic fenestration, cyst-peritoneal shunting, or marsupialization.
- Surgery is typically recommended only when cysts cause clear neurological symptoms such as headaches, seizures, neurological deficits, or increased intracranial pressure.
- For patients with mild symptoms, conservative management with regular monitoring through MRI scans may be appropriate.
- Pain management with standard analgesics like acetaminophen or NSAIDs can help control headaches while awaiting definitive treatment. The goal of surgery is to decompress the cyst and restore normal cerebrospinal fluid circulation.
- Recovery typically requires several weeks, with follow-up imaging to ensure successful treatment. Surgical intervention is justified because symptomatic arachnoid cysts can progressively enlarge and cause permanent neurological damage if left untreated, though the risks of surgery must be weighed against potential benefits in each individual case, as noted in 3, 4, 5. Key considerations in choosing a surgical approach include the cyst's location, size, and the patient's symptoms, with endoscopic fenestration offering a minimally invasive option that can reduce the risk of postoperative complications, as seen in 1, 2.