Treatment of chronic subdural hematoma with arachnoid cyst ; The maning of radiologic findings of arachnoid cyst, case report

초록

Object ; Arachnoid cyst(AC) is a relatively common congenital intracranial mass lesion that originated from abnormal development of meninges. AC often accompany with cSDH. In case of coexisting with CSDH, AC is easily confused to hematoma which may need surgical procedure. The authors have experienced a case that AC with CSDH pts who were treated by burrhole drainage, and introduce the treatment option and radiologic findings which were mimic to intracystic hematoma of AC coexisting with CSDH Patients ; A 19 yrs old man came to our hospital with continuous headache for 2 months ago, and vomiting at 3 days ago. He was alert, and no focal neurologic deficit. Emergent brain CT scan revealed CSDH in left side, and there are suspicious AC in the ipsilateral temporal lobe, which cannot be ruled out hematoma. We think this lesion is CSDH with hemorrhagic AC, however they showed similar signal in the MRI.. Thus, burr hole drainage of CSDH was performed. Results ; on and after op. he has been decreased the headache, and discharged without neurologic deficit at 8 day after op. In immediate postop. Radiologic findings, inner component of AC changed to CSF density and later being more like CSF in repeat exam. Discussion ; In some publicating reporting AC with CSDH, the rdiologic findings in the AC seems like hematoma is actually confirmed CSF in operative finding. A suggested hypothesis was characteristics of microscopic structure of CSDH membrane and AC. The breakdown products of CSDH was infiltrated into the AC seems to be a hematoma at radiologic evaluation. Either AC unfoldings again after compression or penetration are both possible, however there is no report about relationship between both space.