Recurrence of Arachnoid Cysts

Arachnoid cysts (ACs) are benign lesions, arising from duplication of the endomeninx in embryogenesis. While often managed conservatively with serial imaging, they may become symptomatic presenting with a concern for elevated intracranial pressure, seizures, or focal neurological deficits. A variety of surgical treatment options exist, ranging from cyst fenestration to cyst shunting. Although the surgical success rate for these treatment options is often high, ACs may recur in an early or delayed fashion. Recurrence may arise from inadequate fenestration into the surrounding cerebrospinal fluid spaces, gradual closure of surgically created stomas, or shunt failure. Here we explore the various treatment options and the associated AC recurrence rate following surgical intervention.