Multidisciplinary approach to the prenatal diagnosis and post natal management of a large suprasellar arachnoid cyst: A case report

Arachnoid cysts are intra-arachnoid sacs filled with cerebrospinal fluid representing a rare occurence in neonates. We report the case of a suprasellar arachnoid cyst diagnosed prenatally at 21 weeks gestation on routine obstetric ultrasound. A cystic lesion was picked up incidentally at routine antenatal scan. The cyst was noted to be increasing in size over a series of radiological scans. The cyst was diagnosed as a suprasellar arachnoid cyst compressing the third ventricle and bilateral lateral ventricles. A left pteryonal craniotomy for cystocisternostomy of large suprasellar cyst was performed initially. Within a month the cyst recurred with clinical and radiological evidence. An Endoscopic Third Ventriculostomy (ETV) with fenestration was performed. The patient was shifted to the NICU and discharged after 3 days in a stable condition. Patient was followed after 1 week and reassured and advised for one year follow-up.