Surgical management of complicated arachnoid cysts: A case series.

backgroundArachnoid cysts are mostly benign, cerebrospinal fluid-filled sacs within the arachnoid membrane. Although they are often asymptomatic and discovered incidentally, they can also present with serious complications such as hemorrhage or rupture. This study aims to highlight the clinical presentation, radiological findings, and surgical management of complicated symptomatic arachnoid cysts in a case series. CASE PRESENTATION: In this case series, we describe three patients with complicated arachnoid cysts: two children and one older adult. Although all three cases were initially managed conservatively, surgical intervention was eventually required due to worsening clinical symptoms. Surgical interventions included craniotomy with cyst fenestration in case one, subdural-peritoneal shunt in case two, and burr-hole drainage in the third. Presentations ranged from isolated headaches to focal neurological deficits. Outcomes varied: two patients had full clinical and radiological recovery, while one elderly patient passed away postoperatively due to myocardial infarction unrelated to neurosurgical complications. DISCUSSION: These cases underscore the unpredictable nature of arachnoid cysts and how symptoms, age, and overall health can influence treatment plans and outcomes. Imaging plays a key role in diagnosis, while management must be carefully tailored to each case.

conclusionThese cases highlight the clinical variability and potential for complications from arachnoid cysts. Therefore, individualized management, taking into account patient age, characteristic symptoms, and comorbidities, is not just important, but essential for successful outcomes.