Symptomatic increased intracranial pressure due to arachnoid cysts.

Intracranial arachnoid cysts are typically benign lesions, but rarely, they may cause signs and symptoms relating to increased intracranial pressure. We report 4 pediatric patients with arachnoid cysts who received successful surgical treatment after failing to respond to conservative medical therapies. After undergoing a shunting procedure, each patient experienced improvement in symptoms, resolution of optic disc swelling, and reduction or elimination of medications necessary to manage the condition. These cases illustrate the potential for arachnoid cysts to outstrip compensatory mechanisms and cause signs and symptoms requiring definitive surgical intervention.