Operative management of pediatric intracranial arachnoid cysts

In this study, 14 cases of pediatric patients with arachnoid cysts treated between 1995 and 1999 are reported. Six children with mild symptoms and small cysts that remained stable on follow-up studies have not required surgical intervention. Fenestration was done through open craniotomy for two patients and through endoscopy for another two patients. Three of these children treated initially by fenestration showed clinical and radiographic recurrence of the cysts within a period of 2 to 15 months postoperatively and have undergone cystperitoneal shunting. Thus, only one of the four patients initially treated by fenestration remained shunt-independent after a follow-up period of three years. The other four patients were initially treated by cystperitoneal shunting and all improved postoperatively. Shunt revision has been necessary because of cyst recurrence in one of these four patients. Cyst location influenced the success of shunt treatment as none of the five middle cranial fossa cysts treated by shunting required revision