A cystic brain lesion is a fluid-filled sac in the brain that usual contains cerebrospinal fluid. Cystic brain lesions vary in size, type, and location in the brain. The cause of a cystic brain lesion is unknown, though usually they are congenital (present at birth).

There are several different types of brain cysts. Our pediatric neurosurgeons frequently see pediatric patients with arachnoid cysts, colloid cysts, and pineal cysts. Arachnoid cysts are the most common type of brain cyst, and can occur anywhere in the brain but most commonly in the temporal fossa or the posterior fossa. Colloid cysts are usually found incidentally and are treated if they are large or likely to cause hydrocephalus. Pineal Cysts are fluid structures that form on the pineal gland and are treated when they are large (greater than 2cm) and cause symptoms such as debilitating headaches or eye movement problems.

Large brain cysts can block the normal flow of cerebrospinal fluid, which can cause increased pressure on the brain. Cysts can also leak into other areas of the brain, or blood vessels on the cyst’s surface can bleed into the cyst causing a hematoma. If left untreated, cysts can cause neurological damage.

Common symptoms of a cyst on the brain include headache, nausea, vomiting, balance problems, seizures, vision loss and hearing loss. Since these symptoms can be associated with other medical conditions, it is important to first discuss concerns about your child’s health with your pediatrician.

If your child’s pediatrician detects a brain cyst, your pediatrician will refer you to a pediatric neurosurgeon for evaluation, diagnosis, and treatment.

Cystic Lesions Treatment

Brain cyst treatment is determined by the location, size, and type of cyst. Children with a small brain cyst, a cyst that is not changing or causing pressure on the brain, may not require surgery. Our pediatric neurosurgeons may monitor the cyst’s growth with routine imaging appointments. Surgery is recommended for patients with symptoms to alleviate the symptoms and prevent neurological damage.

During a surgical procedure called fenestration, our pediatric neurosurgeons use a minimally invasive approach to reach the cyst with an endoscope or microscope and then open it to release the inside fluid. This procedure may eliminate the need for a shunt or implanted hardware.

In some cases, a shunt may be placed into the brain cyst to drain the fluid away from the brain. This is usually done if the cyst fills back up with fluid after fenestration. Consult with your pediatric neurosurgeon to find out which treatment option is best for your child.


We offer weekly pediatric neurosurgery clinics in Chapel Hill, Raleigh, Pinehurst, and Wilmington. Visit our pediatric neurosurgery clinic locations page for the clinic or hospital nearest you or call 919-445-2410 to schedule an appointment.