Chronic Subdural Hematomas Associated with Arachnoid Cysts: Significance in Young Patients with Chronic Subdural Hematomas

Abstract

Although arachnoid cysts (ACs) are associated with chronic subdural hematomas (CSDHs), especially in young patients, the detailed features of CSDHs associated with ACs remain poorly understood. The objective of this study was to clarify the relationship between the location of CSDHs and ACs and the significance of ACs in young patients with CSDHs. We retrospectively assessed 605 consecutive patients 7 years of age and older who were diagnosed with a CSDH between 2002 and 2014. Twelve patients (2%) had ACs, and 10 of the 12 patients were 7–40 years of age. Patients with ACs as a complication of CSDHs were significantly younger than those without ACs (p < 0.05). Three different relationships between the location of CSDHs and ACs were found: a CSDH contacting an AC, an ipsilateral CSDH apart from an AC, and a CSDH contralateral to an AC. In 21 patients with CSDHs who were 7–40 years of age, 10 (47.6%) had ACs (AC group) and 7 (33.3%) had no associated illnesses (non-AC group). All 10 young patients with ACs showed ipsilateral CSDHs including a CSDH apart from an AC. All 17 patients in both the AC and non-AC groups showed headache but no paresis at admission. The pathogenesis of CSDHs associated with ACs may be different among the three types of locations. The clinical characteristics of patients with a combination of a CSDH and an AC including headache as a major symptom may be attributed to young age in the majority of patients with ACs.

Chronic subdural haematoma associated with arachnoid cyst of the middle fossa in a soccer player: Case report and review of the literature

“…13 patients on admission presented with CSDH [5,[7][8][9][10][11][12][13][14][15][16]18,19]. 11 patients had midline shift [5,[7][8][9]11,12,15,16,18], in 1 case the midline structure was on axis [10].…”

“…11 patients had midline shift [5,[7][8][9]11,12,15,16,18], in 1 case the midline structure was on axis [10]. and in 2 cases there was no mention on midline shift or other signs of raised intracranial pressure [14,19].…”

“…About surgical procedure, in our review 7 patients underwent single burr hole drainage and irrigation of the CSDH; the cyst was left intact as in our case [9,12,[14][15][16]18,19]. Six patients underwent an open craniotomy with cyst fenestration [5,7,8,11,13,19] In one of these, the patient with the subdural hygroma and midline shift, a cistoperitoneal shunt was also performed [13]. In one case the surgical procedure was not well speci ied [10].…”

“…Intracystic hemorrhage was seen in 6 patients [5,[7][8][9]11,15]. In 6 patients there was no evidence of intracranial hemorrhage [9,10,12,14,18,19] In one case this particular was not reported [16].…”

“…There was not recurrence from the irst surgery in 13 cases [5,[7][8][9][10][11][12]14,15,[17][18][19], whereas in 2 cases no follow up was reported [13,16].…”