Temporal Fossa Arachnoid Cysts Presenting as Chronic Subdural Hematomas Report of Two Cases and Brief Review of the Literature

Abstract

Panagopoulos Dimitrios, Mitsios Andreas and Sfakianos Georgios

Introduction: 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 [1]. Majority of arachnoid cysts, particularly those of smaller sizes, have a benign uneventful lifetime course [2]. Chronic subdural hematoma is one of the commonest diseases encountered by a neurosurgeon in daily practice. It is however rarely seen in young patients. Congenital arachnoid cysts have been implicated in both traumatic and spontaneous chronic subdural hematoma in young individuals. However, because most bleeding after trauma is delayed, it is often overlooked [3]. Arachnoid cyst - associated chronic subdural hematoma differs significantly from its counterparts without AC in epidemiologic, demographic, and clinical characteristics [4]. Optimum treatment strategies to address the chronic subdural hematoma and arachnoid cyst are not very well described [5]. We report two cases of Arachnoid cyst - related chronic subdural hematoma in young individuals, who were treated with evacuation of chronic subdural hematoma with craniotomy, without addressing the cyst itself. Fenestration and cerebrospinal fluid diversion should be reserved only as secondary procedures [5].

PDF