Background Brain herniation (BH) into arachnoid granulation has been remarkable in recent years. Purpose To evaluate the damage in herniated parenchyma into the giant arachnoid granulation (GAG) and to investigate the clinical–demographic importance of this damage. Material and Methods Patients with BH into GAG were retrospectively included in the study. Each of the patients had at least one high-resolution 3D magnetic resonance imaging (MRI) sequence. The arachnoid granulation dimensions, locations, and origin of herniated parenchyma were evaluated by two experienced radiologists. The demographic and symptomatic features of the patients were recorded from the hospital database. Results A total of 27 patients (21 females, 6 males; age range 6–71 years; mean age 41.3 years) were found to contain BH into GAG. It was most commonly seen in the transverse sinus (67%); the origin was most common in the cerebellar parenchyma (56%). Abnormal signal and morphology were detected in herniated parenchyma in 11 (47%) patients, atrophy in six, and atrophy and gliosis in five. The most common complaints were headache (47%), while other frequent symptoms were vertigo (15%) and blurred vision (11%). There was a statistically significant positive correlation between frequency of damage in herniated brain parenchyma and the maximal size of GAG ( P<0.05). Conclusion In patients with BH into GAG, parenchymal damage may be associated with various symptoms, such as headache and vertigo, although they have not been statistically proven. It is important to carefully evaluate hernia tissue, as the risk of tissue damage may increase in larger GAGs.

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Osteochondroma is the most common benign bone tumor but it rarely arises from the scapula. Scapulothoracic bursitis is quite rare and osteochondroma is one of the unusual causes of this condition. Synovial chondromatosis may occur extremely uncommonly in this bursa. We reported an unusual case of scapulothoracic bursitis with synovial chondromatosis which is caused by osteochondroma. To the best of our knowledge, there is no defined chondromatosis in the scapulothoracic bursa secondary to scapular osteochondroma in the literature.An osteochondroma originating from the inner surface of the scapula can irritate this bursa and scapulothoracic bursitis may develop. Clinical manifestations are usually pain and swelling on the posterior chest wall. Patients may also declare crepitation by shoulder rotation. Ultrasonography can reveal a fluid collection between the serratus anterior muscle and chest wall. On computed tomography (CT) a hypodense, well-demarcated cystic mass may be seen at this location. Its magnetic resonance (MR) imaging features are similar to other cystic lesions. It is hypointense on T1-weighted images and hyperintense on T2-weighted images. Synovial chondromatosis or osteochondromatosis is a benign synovial metaplastic proliferation that occurs extremely uncommonly in bursae. When we searched 'large scapulothoracic bursa chondromatosis' phrases in lliterature review of Chochran Database and Web of Science, we could not find any case reports of synovial chondromatosis in large scapulothoracic bursa. The bursal chondroid bodies appear hypointense on T1-weighted images and hyperintense on T2-weighted images but the signal intensity decreases in all sequences as the calcific or ossific component of these nodules increases. We here report an unusual case of scapulothoracic bursitis with synovial osteochondromatosis which is caused by osteochondroma. A written informed consent was taken from the patient.

Osteomas are benign bone tumors commonly involving paranasal sinus walls. They are divided into three groups as ivory, mature, and mixed form. We reported demonstrative radiological features of an unusual case of giant osteoma presenting with proptosis and diplopia.