Endoscopic Approach to Arachnoid Cysts

Arachnoid cysts (ACs) are fluid collections commonly located throughout the intracranial and spinal compartments as they commonly result from splitting of the normal arachnoid membrane. Generally asymptomatic, these lesions can cause symptoms in pediatric and adult patients and can expand over time. As the AC expands or leads to symptoms, secondary to mass effect or elevated intracranial pressure, surgical intervention is considered. Surgical approaches such as open, endoscopic, or combined open-endoscopic with cyst fenestration and with or without cyst excision are all potential considerations. We highlight the history of neuroendoscopy, indications for endoscopic use, technique, and the strengths and limitations of endoscopic treatment of ACs.