Subdural hygroma due to traumatic rupture of a middle cranial fossa arachnoid cyst that has transformed into a chronic subdural hematoma after burr hole operation: A case report.

Surgical neurology international Pub Date : 2025-02-28 eCollection Date: 2025-01-01 DOI:10.25259/SNI_980_2024
Seigo Kimura, Daiji Ogawa, Hirokatsu Taniguchi, Masahiko Wanibuchi
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Abstract

Background: Middle cranial fossa arachnoid cysts (MFACs) cause subdural hygromas due to head trauma or spontaneous rupture. We report the case of a patient who has performed burr hole surgery for subdural hygroma and chronic subdural hematoma (CSDH) caused by the rupture of an arachnoid cyst.

Case description: A 30-year-old man fell off a motorbike and hit his head. Head computed tomography (CT) revealed left MFAC and left subdural hygroma. The subdural hygroma increased over time, and the symptoms of intracranial hypertension developed. Therefore, burr hole operation was performed without the use of a subdural drain. Approximately half a month after surgery, head CT revealed that the density of the arachnoid cyst and subdural hygroma increased and that the subdural hygroma transformed into CSDH. Therefore, a burr hole operation was performed again, and a hematoma cavity drain was left. After surgery, the symptoms of intracranial hypertension improved, and subdural collection did not recur.

Conclusion: The increase in CSDH may have disrupted the flap-valve mechanism of the arachnoid cyst and subdural collection. When performing a burr hole operation for a subdural hygroma caused by the rupture of an arachnoid cyst, placement of a subdural drain may be desirable, and consideration of the possibility of CSDH is necessary.

颅中窝蛛网膜囊肿外伤性破裂,经钻孔手术后转变为慢性硬膜下血肿所致的硬膜下血肿1例。
背景:中颅窝蛛网膜囊肿(MFACs)是由头部外伤或自发性破裂引起的硬膜下积液。我们报告的情况下,病人进行钻孔手术硬膜下湿肿和慢性硬膜下血肿(CSDH)引起的蛛网膜囊肿破裂。案例描述:一名30岁男子从摩托车上摔下来撞到了头部。头部计算机断层扫描显示左侧MFAC和左侧硬膜下水瘤。随着时间的推移,硬膜下水瘤增加,颅内高压症状出现。因此,在没有使用硬膜下引流的情况下进行钻孔手术。术后约半个月,头部CT显示蛛网膜囊肿及硬膜下水肿密度增大,硬膜下水肿转变为CSDH。因此,再次行毛刺孔手术,留下血肿腔引流。手术后,颅内高压症状改善,硬膜下积液未复发。结论:CSDH的升高可能破坏了蛛网膜囊肿和硬膜下收集的瓣瓣机制。当对蛛网膜囊肿破裂引起的硬膜下水肿进行钻孔手术时,可能需要放置硬膜下引流管,并考虑CSDH的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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