title: Development of intracranial hypertension after surgical management of intracranial arachnoid cyst: report of three cases and review of the literature.
abstract: OBJECTIVE
  To describe three cases of delayed development of intracranial hypertension (IH) after surgical treatment of intracranial arachnoid cyst, including the pathogenesis of IH and a review of the literature.
  
  
  METHODS
  A retrospective and prospective analysis of three male patients (two 18 years old and one 45 years old) was performed. All patients underwent surgical intervention for symptomatic intracranial arachnoid cyst in the form of fenestration of the cyst and a cystoperitoneal shunt.
  
  
  RESULTS
  All three patients presented at a later stage with new-onset headaches after the initial management of arachnoid cyst. Magnetic resonance imaging and magnetic resonance venography ruled out any intracranial vascular pathology. Lumbar puncture and intracranial pressure monitoring showed increased intracranial pressure suggestive of idiopathic IH. To manage IH, intracranial pressure monitoring, cystoperitoneal shunt, ventriculoperitoneal shunt, and lumboperitoneal shunt were performed.
  
  
  CONCLUSIONS
  The pathogenesis of delayed development of IH in this clinical setting is not clearly elucidated. When intracranial arachnoid cysts are treated, the possibility of future development of IH should be borne in mind. Delayed presentation with headaches in patients after treatment of intracranial arachnoid cysts should raise the possibility of IH.
authors.affiliation: Department of Neurosurgery, Cork University Hospital, Wilton, Cork, Republic of Ireland. Electronic address: ckaliaperumal@gmail.com.
authors.forename: Chandrasekaran
authors.initials: C
authors.lastname: Kaliaperumal
authors.forename: Brendan
authors.initials: B
authors.lastname: O'Connor
authors.forename: Charles
authors.initials: C
authors.lastname: Marks
mesh_terms: D000293:Adolescent; D000328:Adult; D016080:Arachnoid Cysts / Q000601:surgery*; D015170:Cerebrospinal Fluid Pressure; D002557:Cerebrospinal Fluid Shunts; D003399:Craniotomy; D004322:Drainage; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019586:Intracranial Hypertension / Q000209:etiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012189:Retrospective Studies; D056124:Slit Ventricle Syndrome / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Arachnoid cyst; CP; CSF; CT; Cerebrospinal fluid; Computed tomography; Cystoperitoneal; Cystoperitoneal shunt; ICP; IH; Intracranial hypertension; Intracranial pressure; LP; Lumboperitoneal; Lumboperitoneal shunt; Slit-ventricle syndrome; VP; Ventriculoperitoneal; Ventriculoperitoneal shunt