Pillai Promod, Menon Sajesh K, Manjooran Raju P, Kariyattil Rajiv, Pillai Ashok B, Panikar Dilip
Department of Neurological Surgery, the Ohio State University Medical Center, Hamilton Hall, Neil Avenue, Columbus, Ohio 43210, USA.
J Med Case Rep. 2009 Feb 9;3:53. doi: 10.1186/1752-1947-3-53.
Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.
We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.
It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.
颅内蛛网膜囊肿被认为是一种先天性畸形,好发于颞窝。它们通常无症状,但有时会因囊肿增大或出血而出现症状。有多个病例报告称蛛网膜囊肿在头部外伤后因出血并发症而出现症状。在这些病例中,出血通常局限于蛛网膜囊肿同侧。颞窝蛛网膜囊肿患者发生对侧硬膜下血肿的情况很少见,医学文献中的报道也较少。
我们报告两例(一名23岁男性和一名41岁男性)颞窝蛛网膜囊肿患者在头部受伤后并发硬膜下血肿。两名患者均在颞窝蛛网膜囊肿对侧出现硬膜下血肿。在存在颅内蛛网膜囊肿的情况下,缺乏足够的颅内缓冲可能导致头部外伤后不仅同侧而且对侧的桥静脉受损。
识别并报告颅内蛛网膜囊肿的这种罕见并发症很重要,这样可以在头部外伤后向无症状的颅内蛛网膜囊肿患者告知此类可能性。