Abstract
IntroductionIntracranial 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. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.Case presentationWe report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.ConclusionIt is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.
Highlights
Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa
It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma
We report two patients with temporal fossa arachnoid cysts who experienced contralateral subdural hematomas following head trauma
Summary
Arachnoid cysts are believed to be developmental anomalies and are often documented as incidental findings on imaging [1]. We report two patients with temporal fossa arachnoid cysts who experienced contralateral subdural hematomas following head trauma. Case 1 A previously asymptomatic 23-year-old man was examined in the emergency services unit of the referring hospital following a fall while riding a bicycle He reported no loss of consciousness and no external injuries but was complaining of mild headache and nausea. Case 2 A 41-year-old man presented to our out-patient unit with an increasingly severe headache and nausea of 2 weeks' duration. He recalled sustaining a trivial fall about 12 weeks prior to presentation, with no loss of consciousness or any external injuries. The hematoma and hygroma were evacuated by bilaterally placed burr holes, followed by an uneventful recovery
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