Arachnoid Cyst

What are Arachnoid Cysts?

Arachnoid cysts AKA leptomeningeal cysts are congenital lesions that arise during development from splitting of the arachnoid membrane.  The arachnoid membrane is a thin covering over the surface of the brain.  The incidence of arachnoid cysts is approximately 5 in 1000.  There are 2 types of histological findings:

Simple arachnoid cyst: This type contains a lining that is capable of active CSF secretion.

Complex arachnoid cyst: This type contains a more complex lining which may also contain neuroglia, ependymoma, and other tissue types.

Symptoms of Arachnoid Cysts

Most arachnoid cysts that become symptomatic do so in early childhood however few may become symptomatic later in life..  The presentation varies with location of the cyst, and often appears mild considering the large size of some.  Typical presentations include:

  • Seizures
  • Headache
  • Hemiparesis
  • Lethargy
  • Developmental delay
  • Nausea and vomiting

Diagnosis of Arachnoid Cyst

MRI and or CT scan may be used to make the diagnosis of arachnoid cyst. A cisternogram may also be performed in an effort to determine if the fluid filled cyst cavity is in continuity with the subarachnoid space.

Treatment for Arachnoid Cyst

Treatment for arachnoid cyst is usually not necessary in patients who are asymptomatic. Various treatment options for symptomatic patients are listed below:

Drainage by needle aspiration or burr hole evacuation.  This procedure tends to be simple and quick however has a high rate of recurrence.

Craniotomy with excision of cyst wall and fenestration into the basal cisterns.  This method permits direct visualization of cyst and allows evaluation and treatment of bridging vessels that may pose a danger to the patient.

Shunting of cyst into the peritoneum.  This method offers definitive treatment however the patient becomes shunt dependent and has associated risk of shunt infection.

Even after successful treatment of the arachnoid cyst a portion may remain due to remodeling of bone and chronic shift of brain contents. Further neurosurgical intervention may be necessary.

At Princeton Neurological Surgery, Dr. Lipani is a board certified fellowship trained neurosurgeon in New Jersey and specialist in the treatment for arachnoid cyst. Dr. Lipani treats patients from around the world as well as locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth and Mercer Counties for various brain conditions such as brain tumors, arachnoid cysts, Chiari malformation and hydrocephalus. Dr. Lipani offers image guided brain surgery approaches and the latest in noninvasive radiosurgery procedures, tailored to the needs of each patient. If you want state-of-the-art treatment for your brain condition, or to learn more about our services, call or email us to schedule a consultation at our offices in Hamilton or Bridgewater, New Jersey!

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If you would like more information about our services or to schedule an appointment, feel free to fill out our convenient contact form or call us directly at 609-890-3400.

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