Arachnoid cysts (ACs) are benign, congenital, fluid-filled
compartments between two layers of the arachnoid membrane. In the majority of
cases, ACs are asymptomatic and detected as an incidental finding on imaging. A
case of spontaneous intracystic hemorrhage into an arachnoid cyst and
ipsilateral subdural hematoma with no history of trauma is reported. A
23-year-old male presented with a history of headaches for 2 months at a
referring hospital. He was treated conservatively and brought to our hospital
after an episode of seizure and vomiting with a worsening of the headache.
Non-contrast head CT and MRI demonstrated an arachnoid cyst with hemorrhage
within it in the left temporal fossa and early subacute subdural hemorrhage
along the left frontotemporoparietal cerebral convexities.
Frontotemporoparietal craniotomy with subdural haematoma evacuation and
marsupialisation of the arachnoid cyst was performed. Until a postoperative
year, the patient had no headache and no neurological deficits. Arachnoid cysts
are incidentally detected on neuroimaging. Hemorrhage into the cyst is a rare
complication following head trauma. Subdural hygromas and hematomas are also
rare associations and less than 30 cases of arachnoid cysts with spontaneous
hemorrhage are reported in literature. Although very rare, spontaneous
intracystic hemorrhage into an arachnoid cyst may occur and the possibility of
such a complication should be considered in the evaluation of patients with
raised intracranial pressure and associated intracranial hemorrhage elsewhere.
Author(s) Details:
Satyanarayana Kummari
Department of Radiodiagnosis, All India Institute of Medical
Sciences, Nagpur, India.
RK Rao Vedula
Department of Radiodiagnosis, Krishna Institute of Medical Sciences,
Telangana, India.
Please see the link here: https://stm.bookpi.org/NVMMS-V6/article/view/14285
