Hello dear and welcome to the medhelp forum. Usually these arachnoid cysts are asymptomatic and are an incidental observation in an MRI brain done for other purposes. Sometimes one may have epilepsy, some cognitive deficits, headaches, and focal neurological deficits. The neurologist needs to be watchful of any increase in size, raised intracranial pressure and papilledema or optic disc swelling which can lead to permanent vision loss. Surgical excision would be needed only if there is a progressive increase in size and mass effect on serial MRI head. Wishing you all the best.
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