An arachnoidal cyst of the brain with post-traumatic hemorrhage: a case report and literature review

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Abstract

BACKGROUND: Arachnoid cysts (AC) are congenital anomalies characterized by a limited accumulation of cerebrospinal fluid between two layers of the arachnoid membrane. The clinical observation is notable for the complete emptying of the subdural hematoma and the straightening of the brain parenchyma (there is only one such case described in the literature).

CLINICAL CASE DESCRIPTION: An 8-year-old patient, who had been observed for left lateral fissure of the brain since birth, was hospitalized at the Almazov National Medical Research Center due to deterioration of his condition after an injury and an episode of physical exertion. Neuroimaging revealed a rupture of an arachnoid cyst with the formation of a chronic subdural hematoma. Drainage of the subdural hematoma was performed. After surgical treatment, regression of clinical symptoms was noted. According to neuroimaging data, the hematoma was emptied and the brain matter was straightened.

CONCLUSION: We have described a clinical case of AC complicated by hemorrhage with formation of subdural hematoma after mild traumatic brain injury and analyzed the literature on this topic. The course of asymptomatic AC can be complicated by hemorrhage that developed spontaneously or against the background of mild traumatic brain injury. Due to the high elastic properties of the brain in children, complete regression of even long-standing AC is possible.

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About the authors

Magomed R. Mamatkhanov

Almazov National Medical Research Centre

Author for correspondence.
Email: magomedniisp@mail.ru
ORCID iD: 0000-0001-7170-7415
SPIN-code: 7426-2245

MD, Dr. Sci. (Medicine)

Россия, Saint Petersburg

Dmitry V. Nizolin

Almazov National Medical Research Centre

Email: dlarinskij@mail.ru
ORCID iD: 0000-0001-8719-0342
SPIN-code: 9141-7638

MD

Россия, Saint Petersburg

Maria L. Pospelova

Almazov National Medical Research Centre

Email: pospelovaml@mail.ru
ORCID iD: 0000-0003-3553-6537
SPIN-code: 1835-0074

MD, Dr. Sci. (Medicine)

Россия, Saint Petersburg

References

  1. Pierre-Kahn A, Sonigo P. Malformative intracranial cysts: Diagnosis and outcome. Childs Nerv Syst. 2003;19(7-8):477–483. EDN: EHJVIJ doi: 10.1007/s00381-003-0773-6
  2. Osborn AG, Salzman KL, Barkovich AJ. Diagnostic imaging brain. 1st ed. Chapter 7. MediPage, Warszawa; 2012. P. 3–9.
  3. Al-Holou WN, Yew AY, Boomsaad ZE, et al. Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr. 2010;5(6):578–585. doi: 10.3171/2010.2.peds09464
  4. Iaconetta G, Esposito M, Maiuri F, et al. Arachnoid cyst with intracystic haemorrhage and subdural haematoma: Case report and literature review. Neurol Sci. 2006;26(6):451–455. EDN: KTBKFQ doi: 10.1007/s10072-006-0532-z
  5. Rogers AJ, Kuppermann N, Thelen AE, et al. Children with arachnoid cysts who sustain blunt head trauma: Injury mechanisms and outcomes. Acad Emerg Med. 2016;23(3):358–361. doi: 10.1111/acem.12887
  6. Aydogmus E, Hicdonmez T. Spontaneous intracystic hemorrhage of an arachnoid cyst associated with a subacute subdural hematoma: A case report and literature review. Turk Neurosurg. 2019;29(6):940–944. doi: 10.5137/1019-5149.JTN.20885-17.2
  7. Nadi M, Nikolic A, Sabban D, Ahmad T. Resolution of middle fossa arachnoid cyst after minor head trauma — stages of resolution on MRI: Case report and literature review. Pediatr Neurosurg. 2017;52(5):346–350. doi: 10.1159/000479325
  8. Khachatryan VA, Samochernykh KA. Endoscopy in paediatric neurosurgery. Saint Petersburg: Branko; 2015. 276 р. (In Russ.)
  9. Tamburrini G, dal Fabbro M, di Rocco C. Sylvian fissure arachnoid cysts: A survey on their diagnostic workout and practical management. Childs Nerv Syst. 2008;24(5):593–604. EDN: GEYVRT doi: 10.1007/s00381-008-0585-9
  10. Spacca B, Kandasamy J, Mallucci CL, Genitori L. Endoscopic treatment of middle fossa arachnoid cysts: A series of 40 patients treated endoscopically in two centres. Childs Nerv Syst. 2010;26(2):163–172. EDN: FGGQTM doi: 10.1007/s00381-009-0952-1
  11. Rakier A, Feinsod M. Gradual resolution of an arachnoid cyst after spontaneous rupture into the subdural space: Case report. J Neurosurg. 1995;83(6):1085–1086. doi: 10.3171/jns.1995.83.6.1085
  12. Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: Neuroradiological evidence and surgical treatment. J Neurosurg. 2009;110(6):1250–1255. doi: 10.3171/2008.4.17509
  13. Islamian PA, Polemikos M, Krauss JK. Chronic subdural haematoma secondary to headbanging. Lancet. 2014;384(9937):102. doi: 10.1016/S0140-6736(14)60923-5
  14. Takayasu T, Harada K, Nishimura S, et al. Chronic subdural hematoma associated with arachnoid cyst. Two case histories with pathological observations. Neurol Med Chir (Tokyo). 2012;52(2):113–117. doi: 10.2176/nmc.52.113
  15. Kim DY, Lee S, Choi BS, Kim JS. Spontaneous disappearance of an arachnoid cyst after burr hole drainage of chronic subdural hematoma. Korean J Neurotrauma. 2019;15(2):159–163. doi: 10.13004/kjnt.2019.15.e15
  16. Wu X, Li G, Zhao J, et al. Arachnoid cyst-associated chronic subdural hematoma: Report of 14 cases and a systematic literature review. World Neurosurg. 2018;109:e118–e130. doi: 10.1016/j.wneu.2017.09.115
  17. Wester K, Helland CA. How often do chronic extra-cerebral haematomas occur in patients with intracranial arachnoid cysts? J Neurol Neurosurg Psychiatry. 2008;79(1):72Y75. doi: 10.1136/jnnp.2007.117358
  18. Liu Z, Xu P, Li Q, et al. Arachnoid cysts with subdural hematoma or intracystic hemorrhage in children. Pediatr Emerg Care. 2014;30(5):345–351. doi: 10.1097/PEC.0000000000000128
  19. Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: Neuroradiological evidence and surgical treatment. J Neurosurg. 2008;110(6):1250–1255. doi: 10.3171/2008.4.17509

Supplementary files

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1. JATS XML
2. Fig. 1. Magnetic resonance imaging of the brain: arachnoid cyst of the left brain lateral fissure, Galassi type 2.

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3. Fig. 2. Magnetic resonance imaging of the brain: arachnoid cyst of the left brain hemisphere with the formation of a chronic subdural hematoma.

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4. Fig. 3. Magnetic resonance imaging of the brain: enlargement of the subdural hematoma and signs of lateral dislocation of midline brain structures.

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5. Fig. 4. Multispiral computed tomography angiography of the brain: no signs of aneurysm and vascular malformation.

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6. Fig. 5. Magnetic resonance imaging of the brain 3 months after surgery: the cyst and hematoma are emptied.

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7. Fig. 6. Magnetic resonance imaging of the brain 6 (a) and 12 (b) months after surgery: complete arachnoidal cyst regression.

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Copyright (c) 2024 Mamatkhanov M.R., Nizolin D.V., Pospelova M.L.

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