Treatment of suprasellar arachnoid cyst--two case reports.

A 10-month-old girl presented with mental retardation and enlarged head, and a 3-year-old girl presented with epilepsy, both due to suprasellar arachnoid cysts. Magnetic resonance imaging demonstrated the suprasellar arachnoid cyst and the relationship between the cyst and surrounding structures. The 10-month-old patient with accompanying hydrocephalus was treated by fenestration of the cyst wall into the basal cistern. Postoperatively, bilateral subdural effusion appeared and subdural-peritoneal shunting was required. Thereafter, she regained the ability to walk. Two years postoperatively, the cyst reenlarged but communication between the cyst and surrounding cisterns and her development was normal, so she has been followed conservatively. The 3-year-old patient presented without hydrocephalus and was treated by cyst-peritoneal shunting using a Codman-Medos programmable valve through craniotomy. Postoperatively, the cyst was reduced and there has been no recurrence for 2 years and 5 months. We consider that cyst-peritoneal shunting is the most effective treatment for suprasellar arachnoid cyst.