PT - JOURNAL ARTICLE AU - Petrus Johannes Steyn AU - Leigh Luella Van den Heuvel TI - Cut it out or wait it out? Case series of middle fossa arachnoid cysts presenting with psychiatric symptoms and a discussion of the ethics of neurosurgical management AID - 10.1136/gpsych-2021-100523 DP - 2021 Dec 01 TA - General Psychiatry PG - e100523 VI - 34 IP - 6 4099 - http://gpsych.bmj.com/content/34/6/e100523.short 4100 - http://gpsych.bmj.com/content/34/6/e100523.full SO - Gen Psych2021 Dec 01; 34 AB - Arachnoid cysts have been linked to neuropsychiatric morbidity. We describe two patients presenting with dissociative and manic symptoms believed to be associated with middle fossa arachnoid cysts. They were managed medically and remitted eventually, but symptoms were resistant. We briefly review the literature to discuss mechanisms by which cysts could cause symptoms and consider whether neurosurgical management would be appropriate. Although neurosurgery can be considered, its role is currently limited by practical and ethical considerations.