Spontaneous subdural haemorrhage from an arachnoid cyst: a case report and literature review

Abstract

We discuss a spontaneous subdural haematoma (SDH) arising from an arachnoid cyst in a healthy adult male, presenting with headache and vomiting. Imaging revealed a large SDH communicating with an arachnoid cyst and intracystic haemorrhage. The patient fully recovered with surgical evacuation. We also discuss the causes of spontaneous SDH, and specific risk factors for bleeding in arachnoid cysts, as well as review the literature on spontaneous SDH from arachnoid cysts - a rare but serious complication.

Arachnoid cysts with spontaneous intracystic hemorrhage and associated subdural hematoma: Report of management and follow-up of 2 cases

“…Complications such as intracystic hemorrhage or cystic rupture are very rarely seen in ACs and could be preceded by a minor head trauma, more likely in larger cysts [9] . However, spontaneous intracystic hemorrhage with or without associated SDH as well as ACs with no intracystic hemorrhage but with associated SDHs or chronic subdural hygromas have been previously reported [2] , [9] , [12] , [16] . Although in most of reported cases the AC and the associated SDH were ipsilateral, a case of SDH contralateral to the AC has also been reported [17] .…”

“…SDHs are among the common observations in neurosurgery practice, and their prevalence is reported to be 13-14 cases per 100,000 subjects, with a high prevalence of unnoticed incidents [12] . The majority of SDHs occur after trauma-induced rupture of the bridging veins [13] .…”

“…Symptoms are usually related to an increased intracranial pressure, size, or location of the ACs. Although most ACs remain stable in a life period, complete disappearance, intracystic hemorrhage, enlargement, and rupture causing subdural hematoma (SDH) may occur spontaneously over their natural course or after exertion, physical activity, or a traumatic insult [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] .…”

Subdural haemorrhage secondary to arachnoid cyst rupture from scuba diving

“…In several cases arachnoid cyst rupture appeared spontaneous. 5 There are no published cases of arachnoid cyst rupture and subdural haemorrhage caused by scuba diving in the literature.…”

“…[2][3][4] In adults, the majority of arachnoid cysts are asymptomatic and usually represent an incidental finding. 1,5 Although rare, there are published reports of subdural haemorrhage secondary to arachnoid cyst rupture in adults. On review of these cases, minor head trauma predominated as a precipitating factor for cyst rupture and subsequent subdural haemorrhage.…”