Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Department of Anesthesiology, Clinical Research Office, Ataturk University, Erzurum, Turkey.
Acta Radiol. 2021 Jun;62(6):799-806. doi: 10.1177/0284185120941829. Epub 2020 Jul 19.
Brain herniation (BH) into arachnoid granulation has been remarkable in recent years.
To evaluate the damage in herniated parenchyma into the giant arachnoid granulation (GAG) and to investigate the clinical-demographic importance of this damage.
Patients with BH into GAG were retrospectively included in the study. Each of the patients had at least one high-resolution 3D magnetic resonance imaging (MRI) sequence. The arachnoid granulation dimensions, locations, and origin of herniated parenchyma were evaluated by two experienced radiologists. The demographic and symptomatic features of the patients were recorded from the hospital database.
A total of 27 patients (21 females, 6 males; age range 6-71 years; mean age 41.3 years) were found to contain BH into GAG. It was most commonly seen in the transverse sinus (67%); the origin was most common in the cerebellar parenchyma (56%). Abnormal signal and morphology were detected in herniated parenchyma in 11 (47%) patients, atrophy in six, and atrophy and gliosis in five. The most common complaints were headache (47%), while other frequent symptoms were vertigo (15%) and blurred vision (11%). There was a statistically significant positive correlation between frequency of damage in herniated brain parenchyma and the maximal size of GAG (<0.05).
In patients with BH into GAG, parenchymal damage may be associated with various symptoms, such as headache and vertigo, although they have not been statistically proven. It is important to carefully evaluate hernia tissue, as the risk of tissue damage may increase in larger GAGs.
近年来，脑疝（BH）进入蛛网膜颗粒的情况显著增加。
评估疝出的脑实质进入巨大蛛网膜颗粒（GAG）的损伤情况，并研究这种损伤的临床-人口统计学重要性。
回顾性纳入患有 BH 进入 GAG 的患者。每位患者均至少有一个高分辨率 3D 磁共振成像（MRI）序列。两名有经验的放射科医生评估了蛛网膜颗粒的尺寸、位置和疝出脑实质的起源。从医院数据库中记录患者的人口统计学和症状特征。
共发现 27 例（21 名女性，6 名男性；年龄范围 6-71 岁；平均年龄 41.3 岁）存在 BH 进入 GAG。最常见于横窦（67%）；起源最常见于小脑实质（56%）。11 例（47%）患者的疝出脑实质存在异常信号和形态，6 例存在萎缩，5 例存在萎缩和胶质增生。最常见的症状是头痛（47%），其他常见症状是眩晕（15%）和视力模糊（11%）。疝出脑实质损伤的频率与 GAG 的最大尺寸之间存在统计学上的正相关（<0.05）。
在 BH 进入 GAG 的患者中，脑实质损伤可能与各种症状相关，如头痛和眩晕，尽管尚未得到统计学证实。仔细评估疝出组织很重要，因为在较大的 GAG 中，组织损伤的风险可能会增加。
