Symptomatic Supratentorial Benign Cysts: Outcome of Surgical Treatment

Background: Benign supratentorial cysts are uncommon lesions. They have multiple forms including arachnoid cysts, neurenteric cysts, and neuroglial cysts. Fenestration and/or excision of the cyst with minimally invasive treatment using a microscope or an endoscope is the standard. The ideal surgical strategy differs substantially among centers due to a lack of prospective data. Aim of the study: The purpose of this study was to present and evaluate the outcome of our institute's strategy for surgical treatment of these cysts that may contribute to the discussion of the debate. Patients and methods: We retrospectively analyzed our data records for patients with symptomatic supratentorial cysts who underwent surgical treatment at the Department of Neurosurgery, Sohag University Hospitals between June 2020 and June 2023. Demographic data, clinical data, preoperative radiology, surgical-related morbidity and mortality, outcome, and long-term follow up either clinical or radiological were recorded. Results: We presented a total of fifteen cases included, 8 (53.3%) were females, and their ages ranged from 2 months to 60 years. Of the included cases, 7 were arachnoid cysts, one was neurenteric cysts, 3 were hemorrhagic cysts and 4 were glioependymal or neuroglial cysts. 14 cases underwent microsurgical excision with or without fenestration to the ventricular system or subarachnoid space, one case underwent VP shunt insertion for the intraventricular cyst, all came with favorable outcomes with no recurrence during the follow up. Conclusion: Supratentorial cysts are uncommon lesions, they have multiple forms including arachnoid cysts, neurenteric cysts and neuroglial cysts. Microsurgical excision of a symptomatic cyst is considered the golden treatment and carries a high success rate with a low risk of morbidity and mortality and low rate of recurrence. VP shunt insertion might be an adequate option for the intraventricular cyst.