A dual-axis cisternal classification for congenital intracranial cystic lesions: implications for surgical strategy and long-term prognosis

Cisternal topography was associated with recurrence, surgical complexity, and postoperative outcome in congenital cystic lesions. Lesions with multicompartmental or midline-paramedian axial spread carry a high-risk profile and warrant extended surveillance beyond five years. This dual-axis anatomical model may inform more tailored operative strategies and long-term follow-up planning, complementing histological diagnosis in modern skull base surgery.