Successful management of sellar and suprasellar arachnoid cysts with stereotactic intracavitary irradiation: an expanded report of four cases.

Abstract

Sellar and suprasellar arachnoid cysts may be asymptomatic or may cause headache, optic nerve compression, endocrine dysfunction, or hydrocephalus. We propose a minimally invasive treatment strategy when intervention is indicated. Four patients with sellar and suprasellar arachnoid cysts presented with headache, visual compromise, and endocrine dysfunction. Two of the four patients previously had undergone unsuccessful surgical intervention. The imaging studies of two patients were diagnostic of an arachnoid cyst. All four patients underwent stereotactic intracavitary radiation with cyst regression and symptomatic improvement. In each patient, the optic chiasm was decompressed successfully. There were no complications from the procedure. Stereotactic intracavitary irradiation of arachnoid cysts proved to be safe and effective. The procedure obviated the need for open cyst fenestration or shunting.