Physical examination is generally not very useful as most cases of arachnoid cysts are diagnosed incidentally, but in larger cysts, depending of the affected region, there may be some findings.

• The majority of the arachnoid cysts are asymptomatic;
• Physical examination findings are more frequent in the large cysts and may be very diverse due to the fact that the symptoms often vary with the location;
• Some of the most prevalent physical examination are:
  • Ataxia;
  • Hearing loss;
  • Visual changes;^[1]
  • Protrusions from the head or spine;
  • Head bobbing;
  • Endocrine issues, e.g. early onset of puberty.^[2]
• There’s a case report from UCLA of a female patient who presented with altered mental status and speech abnormalities.^[3]
• Spinal meningeal cysts, a rare form of arachnoid cysts, usually present with progressive spastic or flaccid paraparesis or quadriparesis in the second decade of life. 10% may present with monoparesis.^[4]