Spontaneous acute subdural hematoma contralateral to an arachnoid cyst.
Arachnoid cysts (AC) are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%). More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.
Henriques
José Gilberto de Brito
JG
Hospital das Clínicas, Federal University of Minas Gerais, Rua Araguari 1045/301, Belo Horizonte, MG, Brazil. henriques_jgb@hotmail.com
Pianetti Filho
Geraldo
G
Henriques
Karina Santos Wandeck
KS
Fonseca
Luiz Fernando
LF
Melo
Renato Pacheco de
RP
Silva
Márcia Cristina da
MC
Malheiros
José Augusto
JA
D000208:Acute Disease; D016080:Arachnoid Cysts / Q000150:complications* / Q000175:diagnosis; D002648:Child; D046648:Hematoma, Subdural, Intracranial / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed