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Arachnoid cysts are congenital benign fluid collections within the arachnoid membrane-one of the 3 membranous layers that cover the brain and the spinal cord. The cyst is filled with a fluid similar to cerebrospinal fluid (CSF).

Arachnoid cysts may occur either in the brain or along the spinal cord. Most cases present during infancy; however onset of symptoms may be delayed until adolescence when the cyst has enlarged. Intracranial arachnoid cysts are reported to account for about 1% of all intracranial space-occupying lesions. This percentage, however, has probably been underestimated as with the advent of modern imaging techniques intracranial arachnoid cysts have become more frequently detected or diagnosed.

According to their size and location arachnoid cysts may not produce any symptoms and are only discovered incidentally on MRIs of the brain performed for a variety of reasons, or they may enlarge and become symptomatic by exerting pressure on the surrounding brain or by interfering with the dynamics of the CSF circulation.

Arachnoid cysts are more common in males than females. The most frequent localization of congenital intracranial arachnoid cysts is in the middle cranial fossa, constituting more than one half of the total of reported cases. Less commonly, they occur in the sellar and parasellar regions, around the foramen magnum, between the two brain hemispheres, or along the cerebral convexities.

Primary or congenital arachnoid cysts are maldevelopmental anomalies and should be differentiated from secondary arachnoid cysts that are rare and result from a variety of such etiologies as trauma and infection.

The cyst has an incessant tendency to grow or recur but the growing mechanism is still a mystery and the mechanism by which they expand is not fully understood.

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