Common intracranial cystic lesions are benign, including arachnoid cysts, epidermoid cysts, dermoid cysts, hyaline septal cysts, choroid plexus cysts, ventricular cysts, and colloid cysts; there are also some rare cystic craniopharyngiomas, cystic colloid tumors, hemangioblastomas with large cysts and small nodules, and benign cystic meningiomas. This article focuses on a brief description of several common intracranial cystic changes. Arachnoid cyst refers to the congenital existence of an intracranial cyst with a transparent membrane wrapped around colorless and transparent cerebrospinal fluid. It can occur at all ages, and is more common in adolescents. It occurs in the lateral fissure area of the left temporal lobe. It can also occur in the suprasellar pool, the pontine cerebellar region, and the tricerebral ventricle. Its clinical manifestation lacks specificity, some of them may be asymptomatic for life, and most of them are found unintentionally during examination for other reasons, and those who are symptomatic mostly have headache and epilepsy as common symptoms. Cranial CT or MRI can clarify the diagnosis. Choice of treatment: For cysts smaller than 2cm, regular review every six months to a year, no symptoms, no surgery, if there is a tendency to increase, then need surgery. The purpose of surgery is to relieve the compression of the cyst on the brain tissue, eliminate the space-occupying effect, improve the blood supply of the surrounding brain tissue, prevent the recurrence of the cyst, facilitate the development of the brain tissue and reset, and allow the cyst fluid to flow into the normal cerebrospinal fluid, so as to improve the symptoms. Surgical indications include: obvious symptoms of cranial hypertension; secondary epilepsy; severe hydrocephalus; obvious symptoms of compression by huge cysts; secondary intracystic hemorrhage or intracranial hematoma. Surgical methods: 1. Traditional craniotomy including craniectomy and cystocele ventral shunt. 2. Locked-hole craniotomy. 3. Minimally invasive neuro-endophthalmologic cystostomy. Because traditional craniotomy is very traumatic, the patient’s recovery is slow, and there are relatively many complications, while minimally invasive surgery patients recover quickly, have fewer complications, and spend less money on the patient, so most of the patients who need surgery choose minimally invasive treatment or lock-hole technology. 2, Epidermoid cysts intracranial epidermoid cysts, also known as “cholesteatoma”, “pearl tumor”, can be the epithelium left in the tissues of the embryonic developmental period of the development of the epithelium, but also can be the acquired causes (trauma, surgery) so that the epithelial cells are implanted in the subcutaneous growth of the growth of the epithelial cells. The cystic cavity is lined by squamous epithelial keratinized proteins in the form of lamellar desquamation composed of caseous material, and its cystic wall does not contain skin appendages. Incidence rate of 0,2%-1,8%, benign tumors, slow-growing, can develop at any age, usually occurring in the 50-60 years old. Epidermoid cysts are often in the midline or midline paracentral, preferably in the extracerebral cerebral pool, bridge cerebellar angle area. Rarely, they grow in the brain parenchyma. Epidermoid cysts have no specific clinical symptoms and often present as hydrocephalus, with corresponding clinical manifestations depending on the location of the cyst. Cranial CT or MRI can further clarify the diagnosis. The principle of treatment is surgical resection. The modalities are microneurosurgery and neuroendoscopy-assisted microsurgery; the latter is the best combination of modalities for the treatment of this disease. The advantages are 1, the recurrence rate of cysts and the incidence of aseptic inflammation after surgery, and the maximum resection of cysts. 2, small trauma, reducing the pulling of brain tissue and cranial nerve damage. 3, dermoid cysts Dermoid cysts are congenital tumors formed by embryonic residual tissue, originating from ectoderm and mesoderm. Inside the cystic cavity, there are detached sebaceous glands, epithelial cells, hair and sweat glands, and the wall of the cyst is thicker, which consists of skin and skin appendages. It can develop at any age, preferably in children, with a general age of onset around 22 years. It occurs in the posterior cranial fossa, but may also occur in the anterior skull base, paraspinal area, or intracerebral ventricles. Common clinical symptoms are headache, vomiting, seizures, ataxia, gait disturbance, or aseptic meningitis. Cranial CT or MRI can further clarify the diagnosis. Its treatment principle and mode are the same as epidermoid cyst. Cyst of the septum pellucidum, also known as “fifth ventricle”, is considered to be a sign of abnormal brain development, which is a kind of congenital developmental abnormality. It is a congenital developmental abnormality. It may be caused by birth injury or traumatic brain injury, which tears the septum lucidum and fills it with cerebrospinal fluid (CSF), resulting in the distance between the two lateral ventricles being greater than 10mm, which is called septal cyst. They can develop at any age. Generally, there are two types of septal cysts: asymptomatic septal cysts and symptomatic septal cysts. Asymptomatic hyaloid cysts are usually found incidentally during physical examination, while symptomatic hyaloid cysts are characterized by epilepsy, headache, mental abnormality, visual disturbances, hemiparesis, and sensory retardation, etc. The diagnosis can be made by MRI. Cranial MRI can clarify the diagnosis. Asymptomatic hyaloid septal cysts usually do not require treatment, but require regular observation. Neuroendoscopic cyst-lateral ventriculostomy is preferred for patients whose symptoms mainly manifest as epilepsy, or microsurgery, shunt surgery, or stereotactic cystostomy is chosen. The therapeutic effect is good, and the purpose of cyst shrinkage, hydrocephalus disappearance and symptom relief can usually be achieved. The recurrence rate is low. Finally, the author believes that for symptomatic intracranial cystic lesions need to be treated, its first choice of safe and effective minimally invasive surgery neuroendoscopy. For asymptomatic intracranial cystic lesions can choose regular follow-up. If you want to know more about the disease, please consult a specialist.