Most arachnoid cysts (AC-arachnoid cysts) are detected accidentally and usually remain clinically silent.
When they rarely present with symptoms , these are usually: signs of acute intracranial hypertension or the full spectrum of chronic or intermittent symptoms (headache, seizures, psychomotor retardation etc.). Cause-effect in the case of the latter presentation is still a matter of debate and uncertainty.
While in cases of acute intracranial hypertension surgery is necessary and lifesaving due to the severe condition of the patient and can be confirmed by imaging studies, determining indications for surgery in the case of chronically elevated intracranial pressure is usually very difficult. Firstly, because of the wide variety of clinical symptoms, they do not represent a direct threat to the life of the patient. Secondly, the symptoms do not necessarily result from the cysts, they can be coincidental. Thirdly, brain CT and MR images are usually normal apart from the presence of an AC.
In this paper we would like to present our own experience in 3 cases of Sylvian fissure arachnoid cysts in children diagnosed and treated at the University Children’s Hospital in Krakow.