5th Edition of International Neurology Conference 2026

Abstract

Arachnoid cysts are cerebrospinal fluid (CSF) -filled spaces in the arachnoid mater. Different classes and locations of cysts determine the management and outcome for patients. Arachnoid cysts can be divided into two main groups: supratentorial and infratentorial, with the former being more prevalent. These cysts are observed during the early development of foetuses and are identified through routine imaging. These cysts are mostly asymptomatic, incidental findings that cause significant amounts of anxiety amongst parents and clinicians in determining whether interventions are necessary for these children to prevent cyst expansion and subsequent impact on their quality of life. Surgical management and clinical outcomes are somewhat complex, but literature specific to these aspects has not been extensively reviewed. Therefore, the purpose of this review is to discuss the presentation, management, and surgical outcomes of three main types of supratentorial cysts (suprasellar, quadrigeminal plate, and temporal region) in children to help clinicians assess the most appropriate management for these cysts.

In conclusion, endoscopic neurosurgery for supratentorial cysts has improved clinical outcomes. Previously, some literature has reported only a reduction in cyst size as opposed to complete disappearance when cysts have been managed without the use of endoscopes. Furthermore, suprasellar and quadrigeminal cysts have been most effective with neuroendoscopy techniques like shunting and cystocisternostomy, whilst microsurgical fenestrations have been recommended for interhemispheric cysts like TACs. Moreover, children less than 4 years who are diagnosed with cysts experience cyst expansion the most, suggesting an indication for serial imaging and follow-up. On the contrary, children older than 4 are less likely to undergo cyst expansion and, therefore, can be followed up if they become symptomatic. Overall, posttraumatic haemorrhage associated with surgical interventions has been reported to resolve without further surgical treatment. Lastly, the literature has also reported an improvement in hydrocephalus postoperatively.

To improve the understanding of the outcome, clinical management, and understanding of supratentorial arachnoid cysts in the future, a thorough review of literature in the form of a systematic review with quantitative analysis of post-operative data is necessary, which we endeavour to do in the future. In addition, earlier screening for learning difficulties should be introduced for children who present with the general symptoms of arachnoid cysts.