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Arachnoid cysts

Checked: 03-10-2025 by Jenny Henry Next Review: 03-10-2027

Overview

Arachnoid cysts are congenital or acquired cysts filled with CSF found in the brain or spine that are commonly incidental and asymptomatic. They are most commonly seen in the middle cranial fossa. Surgical intervention is rarely required and only required if the patient is symptomatic, i.e. seizures, weakness, hydrocephalus or cognitive impairment. When they are found in the spinal canal, they can cause signs and symptoms of myelopathy.

If there is uncertainty on CT imaging, an MRI is gold-standard for diagnosing an arachnoid cyst.

Referral

Cranial Arachnoid Cyst

All patients with an arachnoid cyst (symptomatic or asymptomatic) should be referred to the Neuro-oncology MDT.

If the patient is asymptomatic from an arachnoid cyst, it is likely no intervention or follow-up will be required.

If a patient is symptomatic and there are more immediate concerns, they should be referred urgently via Referapatient. Patients may be seen by the on-call team or re-directed to the appropriate MDT.

Spinal Arachnoid Cyst

If a patient is symptomatic from a spinal arachnoid cyst, or an MRI report mentions associated cord signal change, please refer them via Musculoskeletal Interface (MSKI) Service.

For asymptomatic spinal arachnoid cysts no referral is necessary however, if there are concerns, these cases can be referred to MSKI as above.



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