Background: Intracranial arachnoid cysts are a common pathological condition that occurs in 2.6% of children. Different surgical procedures had significant failure rate.
Objective: A trial to evaluate effectiveness of open surgical excision to be first line of surgery.
Patients and methods: Twenty three patients with symptomatic arachnoid cyst with radiological evidence, who had a one previous failed surgical intervention, shunting or endoscopic fenestration, underwent open surgical excision of the arachnoid cyst at the Neurosurgery Department of Benha University and Benha Children Hospitals through the period from January 2014 To April 2017.
Results: Twenty three children with intracranial arachnoid cyst (IAC) underwent open surgical excision, total in nine cases (39.1%) and partial in fourteen cases (60.9%). Associated microscopic fenestration to basal arachnoid cisterns is done in thirteen cases. Mean follow up period is 16.36±3.97 months with 77.3% success and 22.7% failure with subsequent treatment by cystoperitoneal shunting. Total excision success is 100% but partial excision is 64.3% with 88.9% of them is associated with microscopic fenestration. Mild early transient complications were reported in only three cases and conservatively treated.
Conclusion: Open surgical excision of IAC has a very good success rate that encourages us to put it as first line of surgical treatment rather than cystoperitoneal shunting or endoscopic fenestration.