title: Giant arachnoid granulation: differential diagnosis of acute headache.
abstract: We present a case of intense, rapidly evolving headache clinically mimicking meningitis, subarachnoid haemorrhage or venous sinus thrombosis. Clinical examination, standard blood work and central nervous system studies were non-contributory and effectively ruled out these diagnoses. Cranial multidetector CT studies before and after application of intravenous contrast medium performed prior to lumbar tap disclosed a non-enhancing ovoid mass filling the superior sagittal sinus. This lesion posed a differential to venous sinus thrombosis, but ultimately fulfilled the criteria of a giant arachnoid granulation. The imaging characteristics and differential diagnosis of giant arachnoid granulations are discussed.
authors.affiliation: Department of Radiology, BG-Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. soeren.peters@ruhr-uni-bochum.de
authors.forename: S A
authors.initials: SA
authors.lastname: Peters
authors.forename: E
authors.initials: E
authors.lastname: Frombach
authors.forename: C M
authors.initials: CM
authors.lastname: Heyer
mesh_terms: D000208:Acute Disease; D000328:Adult; D001099:Arachnoid / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006261:Headache / Q000175:diagnosis*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed