Subdural and intracystic haematomas in an arachnoid cyst secondary to a boxing injury

Abstract

The sport of boxing is a well known cause of brain injury. These injuries can be acute, such as intracranial haematoma, or chronic, such as dementia pugilistica. Acute subdural haematoma (SH) is the most common acute brain injury in boxing, and is the leading cause of boxing fatalities. Even though new protective measures have been adopted to decrease the severity of these injuries, the high incidence of boxing-related injuries continues. Arachnoid cysts are developmental collections of fluid that form within the arachnoid membrane; nearly two-thirds of the cysts occur in the Sylvian fissure (middle cranial fossa) and, for unknown reasons, the left hemisphere is involved twice as often as the right. Middle fossa arachnoid cysts (MFAC) may manifest themselves in several different ways. Most often they remain asymptomatic and are only diagnosed incidentally on computed tomography (CT) or during autopsy. We report the rare case of a previously asymptomatic individual who presented with subdural and intracystic bleeding associated with an arachnoid cyst; the bleeding was secondary to head trauma in a boxing practice match.