Wester K, Helland C A
Section for Neurosurgery, Department of Surgical Sciences, University of Bergen, and Haukeland University Hospital, Bergen, Norway.
J Neurol Neurosurg Psychiatry. 2008 Jan;79(1):72-5. doi: 10.1136/jnnp.2007.117358. Epub 2007 May 8.
Chronic subdural (CSDH) or intracystic haematomas may occur as a complication in patients with arachnoid cysts, even in children and young adults. The aim of this study was to investigate how often an arachnoid cyst is complicated by such haematomas, as this information may be of importance when considering decompressive cyst surgery.
This study includes a total of 241 consecutive, adult and paediatric patients (157 males and 84 females), that were referred to our department for treatment for an arachnoid cyst during the period January 1987-September 2004. Our department is the only neurosurgical department in a well-defined geographical region, with a population of 930,000.
A chronic haematoma was found in a total of 11 patients (4.6%), all harbouring a temporal cyst. For the temporal cysts, the haematoma frequency was 6.5%. Haematomas occurred equally frequently in individuals with small, middle-sized and large temporal cysts, and in the age groups studied and in both genders.
As also reflected in a literature review, intracranial chronic haematomas occur most frequently as a complication of middle fossa cysts. Possible mechanisms behind the formation of haematomas, and the strong associations with temporal fossa cysts, are discussed, with emphasis on the loose attachment of the membrane of the arachnoid cyst to the dura in the middle fossa, and its possible role as an "extra wall" covering easy-bleeding vascular structures in the dura.
慢性硬膜下血肿（CSDH）或囊内血肿可能作为蛛网膜囊肿患者的一种并发症出现，即便在儿童和青年中也会发生。本研究的目的是调查蛛网膜囊肿并发此类血肿的频率，因为在考虑囊肿减压手术时，该信息可能具有重要意义。
本研究共纳入241例连续的成年和儿科患者（男性157例，女性84例），这些患者在1987年1月至2004年9月期间因蛛网膜囊肿转诊至我科接受治疗。我科是一个明确地理区域内唯一的神经外科科室，该区域人口为93万。
共11例患者（4.6%）发现慢性血肿，均为颞叶囊肿。对于颞叶囊肿，血肿发生率为6.5%。小、中、大颞叶囊肿患者，以及所研究的年龄组和男女两性中，血肿发生频率相同。
正如文献综述中也所反映的，颅内慢性血肿最常作为中颅窝囊肿的并发症出现。讨论了血肿形成背后的可能机制，以及与颞窝囊肿的强关联，重点强调了蛛网膜囊肿壁在中颅窝与硬脑膜的疏松附着，及其作为覆盖硬脑膜中易出血血管结构的“额外壁”的可能作用。
