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

OBJECTIVE: Sellar and suprasellar arachnoid cysts may be asymptomatic or ma y cause headache, optic nerve compression, endocrine dysfunction, or hydroc ephalus. We propose a minimally invasive treatment strategy when interventi on is indicated. METHODS: Four patients with sellar and suprasellar arachnoid cysts presente d with headache, visual compromise, and endocrine dysfunction. Two of the f our patients previously had undergone unsuccessful surgical intervention. T he imaging studies of two patients were diagnostic of an arachnoid cyst. RESULTS: All four patients underwent stereotactic intracavitary radiation w ith cyst regression and symptomatic improvement. In each patient, the optic chiasm was decompressed successfully. There were no complications from the procedure. CONCLUSION: Stereotactic intracavitary irradiation of arachnoid cysts prove d:to be safe and effective. The procedure obviated the need for open cyst f enestration or shunting.