Arachnoid Cyst Surgical Procedures & Outcomes

In Arachnoid Cyst Surgery, Arachnoid Cysts, Shunts on August 22, 2012 at 8:09 pm

Procedures and Outcomes:  Arachnoid Cyst Fenestration, Arachnoid Cyst Shunting

The two most common procedures performed on an Arachnoid Cyst are fenestration and shunting. Depending on the size of the cyst, fenestration can either be done endoscopically or after a craniotomy. Endoscopic Fenestration is done by making one or two dime sized holes in the skull. The surgeon then guides the endoscope into the brain until it reaches the arachnoid cyst. Then a small incision is made into the cyst to help the fluid flow out, so that the pressure is relieved.

Craniotomy Fenestration is done by removing a portion of the skull so the surgeon can access the brain. Then an incision is made into the arachnoid cyst during the fenestration, so that the cyst fluid can drain out.


Cysto-peritoneal shunting is the most common form of shunting performed on arachnoid cysts. In this procedure a shunt catheter is placed inside the arachnoid cyst and is attached to a distal tube which allows the cyst fluid to drain down to the abdomen. But in some cases Ventriculo-Perotineal and even Cysto-Pleural shunting are performed on arachnoid cyst patients.

If the arachnoid cyst is in communication with the ventricles, the shunt can be placed in the ventricles and drained to either the abdomen, pleura, jugular vein or heart.


Endoscopic Fenestration

Endoscopic fenestration can achieve positive results, and is minimally invasive. After surgery the patient usually leaves the hospital after 24 hours, if not the same day.

Craniotomy Fenestration

Whenever the brain is open to the air, there is a risk of infection. When a bone flap is removed from the skull, it comes along with a significant amount of pain. But all going well the patient should leave the hospital two to four days after surgery. In some cases the bone flap is wired back onto the skull at a later date, but this sometimes is not necessary.


If possible shunting should be a last resort because the patient can become shunt dependent or suffer shunt related complications in addition to the arachnoid cyst. This can result in multiple surgeries, which are called shunt revisions. There is also an increased risk for infection every time the shunt is revised. If the patient becomes infected, the shunt will need to be externalized while the patient is given antibiotics. The hospital stay for this is quite long and entails at least two surgeries. Unfortunately, even if the surgery (whichever it may be) is successful, and symptoms dissipate, arachnoid cysts can reaccumulate.

If the patient’s first surgery was a craniotomy fenestration, the second surgery is usually placement of a shunt. Some have complete resolution with only one surgery, whereas others need three or four before the cyst stops causing symptoms. This is one of the reasons why Arachnoid Cyst Awareness is pleading with the medical world to introduce more research into this subject, so that a more solid cure can be found.

Feel free to join this discussion by hitting the reply button below. If you would like to share your recovery experience or have any questions feel free and post this in the reply box.

© 2012 ACA Network

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  1. just wondering what the average recovery time is and if it really is necessary to remove the cyst…a cat scan recently revealed I have a 3.4 x 4.5 x 3.2cm deep cyst on the left front temporal lobe. information would be soothing. cheers

    • It really depends on the person because it varies based on age, strength and what your overall immune system is like if you happen to get an infection. A basic endoscopic fenestration normally requires you to be in hospital for 3 or 4 days, sometimes 1 or 2. If there are no complications and you see your symptoms drastically improving, you can usually go back to work or school in a couple of weeks.

      Whether or not you need surgery depends on how the symptoms are affecting your quality of life.

  2. Am 30yrs old lady who was diagnosed with right arachnoid cyst in Jan,2013 via ct scan and mri measuring 4.2 *2.6 due to headache and vomiting among other symptoms,in April,2013 a craniotomy was done to remove the cyst, and now in June,2013 another ct scan was done postoperatively and now the cyst was measuring 3.8 by 1.9 by 3.1 and a density of +2 – +7HU then the surgeon said the brain was expanding well,now I wonder whether the cyst is or inactive not because headache,fatigue and diziness are still present after slight duty.

  3. I have had to Craniotomy Fenestrations and I still have a large cyst,I live day by day with the side affects. I was feeling better up until 3 weeks ago when the headaches came back along with the partial seizures with numbness in my face,arm and leg, I don’t think you ever fully get better you just manage the symptoms as best as you can.

  4. My 12 year old is having surgery tomorrow, holding on to the hopes that this will make her better. Just wondering how many get the Craniotomy Fenestration? That is the type she is having. It is all so fast only a month ago we found out about the surgery. How do you know what type is the best.

  5. My 12 year old will have Craniotomy Fenestration on Oct 7th. I am looking for hopeful info. Leanne how is your daughter?

  6. My 7 month old just had an arachnoid cyst fenestration yesterday. The surgery took 4 painful hours by a top pediatric neurosurgeon here in NYC. The cyst was found during my 28th week sonogram during a twin pregnancy. For the remainder of the pregnancy I was monitored closely with weekly sonos. I had a c-section my son was taken to the NICU for observation and an MRI… He was there for 1day & able to come home with me & his sister on the 4th day. He was healthy besides the cyst, and the neurosurgeon advised we monitor the cyst so that he could grow more. He was seen at 4 weeks, 2.5 months, 5 months, and given an MRI at the end of his 6th month when I noticed a bulge in his soft spot & his eyes being a bit red at times, that was last week, my son has no developmental delays or health issues. After seeing the MRI, surgery was advised right away, it was time and the doctor said it was best while he didn’t show any issues, he was suffering in ways that I or anyone else could see.., that was last week. I type this only because when I first found out about his cyst, I didn’t much positive stories or details of such a case and I want to give other mothers/parents a bit of piece of mind… I cried during the surgery behind dark sunglasses, even thou I knew he was in the best hands in the world. When he was done he slept with a medium size bandage around the incision, he looked fine & peaceful, 45 mins after he drank 6 oz. of breastmilk & went back to sleep. The first thing i noticed was that his eyes were clearer and whiter than they have ever been, and where there was a bulge in his soft spot it was sunken in like a crater. He woke up 3 hrs later, and drank 7 more ozs. Stayed awake for 45 mins & went back to sleep. He had a little pain, which was taken care of with Tylenol & some freakish looking swelling began that evening. I got to sleep in the same bed with him & he ate again like he normally would around 2am…the next day, this morning, he was sitting up babbling and playing, and some of the swelling had already gone down. We were discharged at noon, he has taken Tylenol 4 times since the surgery, he has played with his sister, taken a bath & now fast asleep. I am so happy how things turned out & and am forever thankful to our neurosurgeon, his team, and the hospital staff. Will post again with an update in a couple of weeks when he is all healed up & after a few follow-up visits…

    • I am happy to report that my daughters surgery went very well. She had a few rough days, was in the hospital from Mon-Sat. She is home and her 24 staples was removed yesterday. She says her headaches are already better. I am thankful for the surgery but there was a point in her recovery where I thought it was a bad thing, her hard days was very hard. The dr said some people don’t handle being put to sleep as well as others. I will update after her month and three month check ups. Thanks for your story @M, hope your son stays well are heals fast.

    • M –
      I am so glad that your son’s surgery went so well and hope that all is continuing to go well. I was wondering was your sons fenestration done by craniotomy or endoscopic?

  7. My son has been diagnosed with a cyst on the frontal horns of his brain the size is 2.3cm..he has frequent headaches and his eye sight is always blurred…we r still waiting for the Pittsburgh childrens hospital to get back to me about what kind of cyst it is and what the next step is as well as my 11yr old son having other spots spread throughout his brain its very scary and frustrating when u don’t know what it is…my prayers r with all of u that have gone through or going through this.

    • My son just had his done on the 11th he now gets brief moments of pain on opposite side of head. Wondering if anyone else experienced this

  8. My 3 year old is have arachnoid cyst surgery this morning iam so nervous, this is one of the worst days of my life. Hes doing a cranitomy fenstration, what should I expect?

    • Kevin –
      We are looking at the same having to be done for my 2yr old grandson, how did your childs cranitomy go ?

  9. My grandson was diagnoised with a arachnoid cyst in Oct. 2013, by a cat scan due to complaining that his head hurt and throwing up. Since then we have seen a neurosurgeon and have had a MRI, his cyst has not grown but it is very large and the doctor recommends doing a crainotomy fenestration. Which obviously has left us scared out of our minds. Reading some of the info by other parents and their experience makes us feel like we and Blake can get through this. Thank you all for sharing your experiences especially M. I am so very very scared for him.

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