Arachnoid cyst before drainage! Arachnoid cysts are located within the subarachnoid space and contains cerebrospinal fluid (CSF). It is a pretty common benign lesion and in many cases asymptomatic, if not extremely enlarged. This large arachnoid cyst was a result of gradual enlargement resulting in mass effect and is clearly seen pushing on the brain. It is believed they develop due to a congenital splitting of the arachnoid layer with accumulation of CSF within this potential space. The wall of the cyst is comprised of flattened arachnoid cells forming a thin translucent membrane with no epithelial lining, thus, the risk of rapture is present. Treatment is indicated in symptomatic patients and includes craniotomy with fenestration or excision) or a placement of a cystoperitoneal shunt where the CSF is being drained through a tube into the peritoneal cavity.