Cedeño-Morán Alejandro E, De Jesus Orlando
Neurosurgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Cureus. 2024 Aug 20;16(8):e67280. doi: 10.7759/cureus.67280. eCollection 2024 Aug.
Arachnoid cysts are extra-axial cerebrospinal fluid collections located in the arachnoid space that usually do not communicate with the ventricular system. They are commonly found in the middle cranial fossa around the Sylvian fissure. Most of them are asymptomatic, but subdural collections or intracystic hemorrhages can complicate their natural course. Cases of intracystic hemorrhage and subdural hematoma, especially in the absence of traumatic events, have been scarcely reported. Arachnoid cysts outside the middle cranial fossa are rarely associated with an intracystic hemorrhage. We present the case of a 10-year-old boy with a known right parietal brain arachnoid cyst who complained of progressive headaches for three days. There was no history of trauma. The head CT scan showed a 2-cm isodense subacute subdural hematoma, causing a mass effect on the underlying brain. It was associated with a right parietal arachnoid cyst containing intracystic subacute blood. The symptoms were relieved after burr-hole surgical drainage of the intracystic hemorrhage and associated subacute subdural hematoma.
蛛网膜囊肿是位于蛛网膜下腔的轴外脑脊液聚集，通常不与脑室系统相通。它们常见于中颅窝的大脑外侧裂周围。大多数蛛网膜囊肿无症状，但硬膜下积液或囊内出血会使其自然病程复杂化。囊内出血和硬膜下血肿的病例，尤其是在没有外伤事件的情况下，鲜有报道。中颅窝外的蛛网膜囊肿很少与囊内出血相关。我们报告一例10岁男孩，已知患有右侧顶叶脑蛛网膜囊肿，主诉渐进性头痛3天。无外伤史。头部CT扫描显示一个2厘米的等密度亚急性硬膜下血肿，对其下方的脑组织产生占位效应。它与一个含有囊内亚急性血液的右侧顶叶蛛网膜囊肿相关。经钻孔手术引流囊内出血及相关亚急性硬膜下血肿后，症状缓解。
