Clinical characteristics and treatments of arachnoid cyst combined with chronic subdural hematoma

Abstract

Objective To investigate the clinical characteristics and treatment strategies of arachnoid cyst combined with chronic subdural hematoma. Methods Seventeen patients with arachnoid cyst combined with chronic subdural hematoma, who received treatment in our hospital from February 2008 to March 2016, were chosen in our study; 13 of them were performed burr hole irrigation and drainage, 2 received craniotomy for removing hematoma and cystectomy, and 2 received endoscopic cyst excision and hematoma removal surgery. A retrospectively analysis of clinical characteristics and treatment strategies of these patients was performed. Results Follow up for 0.5-2 years was performed in the 13 patients performed burr hole irrigation and drainage, and no hematoma relapse was noted; one was found rebleeding in the cyst associated with a small amount of subdural hematoma on the 5th d of surgery, and the subdural hematoma was absorbed during the follow-up observation; one was found that the cyst and subdural hematoma both disappeared in the postoperative check, while the cyst reappeared 40 days after surgery, and during the follow-up observation, the cyst was not enlarged and the chronic subdural hematoma was not relapsed. Two patients recovered after receiving the craniotomy for removing hematoma and cystectomy; two patients recovered after receiving the endoscopic cyst excision andhematoma removal surgery. Conclusion For patients with arachnoid cyst associated with chronic subdural haematoma, burr-hole irrigation and drainage are generally selected; for patients with reappeared cyst or hematoma, there is no need to burr hole again or perform the surgery aiming at the cyst in a haste, and follow-up observation is suggested; for patients whose symptoms in the cyst have appeared before hemorrhage or whose hemorrhage appeared recurrently in the cyst, surgery of hematoma removal and cyst excision can be chosen at the same time. Key words: Arachnoid cyst; Chronic subdural hematoma; Operation