1/12. Posttraumatic subdural hygroma: CT findings and differential diagnosis.Subdural hygroma is a cerebrospinal fluid accumulation in the subdural space. It is an epiphenomenon of head injury. CT is the preferred diagnostic imaging modality. Differential diagnosis has to be made with chronic subdural hematoma, and atrophy with enlargement of the subarachnoid space. As time goes by, subdural hygroma either resolves, or it becomes a chronic subdural hematoma. Neurosurgical evacuation is only required when mass effect creates neurologic symptoms.- - - - - - - - - - ranking = 1keywords = arachnoid (Clic here for more details about this article) |
2/12. Ruptured middle cerebral artery aneurysm and bilateral chronic subdural hematomas.BACKGROUND: While rupture of a cerebral aneurysm into the subdural space is rare, aneurysmal subarachnoid hemorrhage in the presence of subdural hematoma(s) is much more uncommon. Such a patient requires changes in routine perioperative management.CASE DESCRIPTION: A patient with a ruptured middle cerebral artery bifurcation aneurysm and bilateral subdural hematomas is presented. He underwent successful aneurysm clipping and subdural hematoma evacuations. At the time of surgery, measures commonly used to obtain brain relaxation were avoided. The patient was kept normovolemic, normocarbic, and normotensive. He recovered completely and resumed his prior occupation.CONCLUSIONS: Changes in standard techniques for a patient undergoing a pterional craniotomy for a ruptured cerebral aneurysm are required when bilateral extra-axial mass lesions are present.- - - - - - - - - - ranking = 1keywords = arachnoid (Clic here for more details about this article) |
3/12. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report.OBJECTIVE AND IMPORTANCE: soccer has become a popular sport, with more than 200 million Federation International football association-registered soccer players worldwide and 16 million participants in the united states. The risk of sustaining a significant head injury from a strike to a soccer ball with the head is unknown, but it may be increased with the presence of an underlying congenital arachnoid cyst. CLINICAL PRESENTATION: We describe the case of a 16-year-old female patient who sustained a large chronic and subacute subdural hematoma without a loss of consciousness from being struck on the head by a soccer ball. Because of the large size of the hematoma and her contralateral symptoms, surgery was performed. INTERVENTION: A temporal craniotomy for evacuation of a large chronic and subacute subdural hematoma with removal and fenestration of the arachnoid cyst resulted in resolution of her symptoms. Rigid craniotomy fixation of this small operative flap should allow the patient to return to soccer participation in the future. CONCLUSION: Although many may not consider soccer a contact sport, recent epidemiological data suggest that it is a common cause of sports-related concussion. In addition, as our case report demonstrates, there is a risk of significant intracranial injury and hematoma formation subsequent to a strike on the head by a soccer ball, and arachnoid cysts may contribute an additional risk of head injury.- - - - - - - - - - ranking = 12.509474681239keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
4/12. Chronic subdural hemorrhage into a giant arachnoidal cyst (Galassi classification type III).The authors present CT and MRI of a patient with an extremely large arachnoidal cyst (Galassi classification type III). The cyst extended from the base of the skull, posterior to the brain stem, on the base of the temporal lobe over the complete convexity of the left hemisphere. The cyst consisted of multiple compartments with intracystic septa and was accompanied by a chronic subdural hemorrhage in the compartments. After contrast agent application, the typical characteristics of chronic subdural membranes were found. Besides bony deformities, a thinning of the inner table was found. The patient underwent craniotomy for evacuation of the hemorrhage and fenestration of the septa while he was free of symptoms. This is a remarkable case proving that chronic local intracranial pressure does not inevitably lead to neurologic symptoms or intellectual disabilities.- - - - - - - - - - ranking = 5.0327231728226keywords = arachnoid, cyst (Clic here for more details about this article) |
5/12. Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles: twelve cases of chronic subdural hematoma associated with arachnoid cyst.Chronic subdural hematoma (CSDH) tends to occur in elderly patients with a history of mild head injury at a few months prior to the onset of symptoms. Intracranial arachnoid cyst is believed to be congenital and sometimes becomes symptomatic in pediatric patients. These two distinct clinical entities sporadically occur in the same young patient. Twelve of 541 cases of CSDH surgically treated in our institution had associated arachnoid cyst. The clinical and radiological characteristics of the cases of CSDH associated with arachnoid cyst were retrospectively analyzed and compared with those of CSDH without arachnoid cyst. arachnoid cysts were located in the middle fossa (eight cases), convexity (two cases), and posterior fossa (two cases). Three cysts were less than 20 mm in diameter. The 12 patients with CSDH and arachnoid cyst (mean age 27.8 /- 19.7 years) were significantly younger (p < 0.001) than the patients with CSDH without arachnoid cyst (69.5 /- 13.7 years). Five of the 12 patients were pediatric cases (< 15 years old). The clinical symptoms were also significantly different. The most frequent symptom was headache followed by vomiting in the patients with arachnoid cyst, while gait disturbance and hemiparesis predominated in patients without arachnoid cyst. hematoma evacuation through burr holes improved the symptoms in all patients with arachnoid cyst. We conclude that even a small arachnoid cyst can be a risk factor for CSDH after mild head injury in young patients and symptoms of increased intracranial pressure are common. hematoma evacuation is adequate at first operation. If the preoperative symptoms persist, additional arachnoid cyst surgery should be considered. The present results also suggest that CSDH formation may be preceded by subdural hygroma caused by the rupture of arachnoid cyst.- - - - - - - - - - ranking = 28.617627365307keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
6/12. Pseudosubarachnoid haemorrhage in subdural haematoma.Two patients with large bilateral subdural haematomas with patterns of non-enhanced brain computed tomography (CT) falsely suggesting coexistent subarachnoid haemorrhage are presented. The CT images showed marked effacement of the basal cisterns with hyperdense signal along the tentorium, sylvian fissure, and the perimesencephalic cisterns. In both cases, the suspicion of subarachnoid haemorrhage led to the performance of angiographic studies to rule out vascular lesions. Thus, recognition of this radiological feature is important to avoid unnecessary testing and treatment delay.- - - - - - - - - - ranking = 6keywords = arachnoid (Clic here for more details about this article) |
7/12. Subdural haematoma associated with an arachnoid cyst after repetitive minor heading injury in ball games.We report the case of a chronic subdural haematoma caused by repetitive heading of a football which led to the diagnosis of a middle fossa arachnoid cyst. The association between arachnoid cysts and subdural haematoma is discussed as are safety implications in sporting injuries.- - - - - - - - - - ranking = 10.722406869634keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
8/12. shaken baby syndrome manifesting as chronic subdural hematoma: importance of single photon emission computed tomography for treatment indications--case report.A boy with shaken baby syndrome first presented at age 3 months with acute subdural hematoma (SDH) and was treated by subdural tapping at a local hospital. Chronic SDH was identified at a rehabilitation center at age 19 months. The chronic SDH appeared to have developed within the preceding 16 months. His physical and mental development was already delayed. Magnetic resonance (MR) imaging revealed a 20-mm thick right chronic SDH with midline shift and small bilateral subdural effusions. The chronic SDH had compressed the right cerebral hemisphere. MR imaging also disclosed bilateral cerebral atrophy. 99mTc-ethylcysteinate dimer single photon emission computed tomography (SPECT) revealed decreased cerebral blood flow (CBF) in the non-hematoma hemisphere, although CBF is said to decrease on the chronic SDH side, especially if midline shift is present. Burr hole craniotomy with external drainage was performed, but the patient showed no change in CBF postoperatively, although the volume of hematoma decreased. The patient was clinically unchanged immediately after the operation. In this case, SPECT measurement of CBF was important in evaluating the pathophysiology of the delays in physical and mental growth. atrophy of the bilateral hemispheres was the major mechanism in the decreased CBF, not the compression by chronic SDH. MR imaging and SPECT can determine the surgical indications for chronic SDH in patients with cortical atrophy.- - - - - - - - - - ranking = 0.0040903966028289keywords = cyst (Clic here for more details about this article) |
9/12. Chronic subdural haematoma and autosomal polycystic kidney disease: report of two new cases.Chronic subdural haematoma (SDH) was recently described in some patients who were suffering from autosomic dominant polycystic kidney disease (ADPKD). It results in various neurological symptoms mimicking those related to intracranial aneurysms, which are relatively frequent in such patients. The authors report two cases of chronic SDH observed in two patients known to have advanced renal failure attributed to ADPKD. Medical imaging failed to reveal features of associated intracranial abnormalities such as aneurysms or arachnoid cysts. Surgical drainage resulted in a good recovery without relapse during a long period of follow up that exceeded 10 years in the first case.- - - - - - - - - - ranking = 1.8075197946198keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
10/12. Chronic subdural haematoma and arachnoid cyst in autosomal dominant polycystic kidney disease (ADPKD).We present the unusual association between chronic subdural haematoma (CSDH), intracranial arachnoid cyst and autosomal dominant polycystic kidney disease (ADPKD) in a 27-year-old man. CSDH is a documented complication of intracranial arachnoid cyst, the incidence of which is increased in patients with ADPKD. awareness of this association may lead to earlier diagnosis of ADPKD and treatment of its systemic complications, including renal insufficiency, systemic hypertension and previously unsuspected intracranial saccular aneurysm. Surgery for CSDH associated with intracranial arachnoid cyst may be complicated by over-drainage of cerebrospinal fluid due to communication between the cyst and the cisternal subarachnoid space, as illustrated in the present case, and the development of epidural haemorrhage.- - - - - - - - - - ranking = 13.534017060856keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
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