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Intracranial arachnoid cysts

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Abstract

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.

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Data availability

No datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Neurosurgery, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 566, Baltimore, MD, 21287, USA

    A. Karim Ahmed & Alan R. Cohen

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A.K.A. wrote the main manuscript text and prepared the figures. A.R.C. oversaw all aspects of manuscript preparation and revision.

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Correspondence to Alan R. Cohen.

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Ahmed, A.K., Cohen, A.R. Intracranial arachnoid cysts. Childs Nerv Syst 39, 2771–2778 (2023). https://doi.org/10.1007/s00381-023-06066-0

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