Protruding arachnoid granulations mimicking dermoid cysts

Beatty, Robert M.; Hornig, Gregory W.; Hanson, E. Jerome

doi:10.1016/s0022-3468(89)80285-4

Cited by 14 publications

(21 citation statements)

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“…The published literature from 1973 to 2023 yielded 41 publications describing GAGs in 169 persons [ 3 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ] ( Table S1 ). This incorporated reports of 146 persons each with a single GAG; 21 persons with at least two GAGs [ 7 , 8 , 9 , 10 , 11 ]; and 2 persons who each exhibited “multiple” GAGs, with three [ 12 ] or four [ 8 ] GAGs being discernible on presented imaging.…”

Section: Resultsmentioning

confidence: 99%

“…Considering the above, the review yielded a total of at least 195 reported GAGs. Of these, 164 (84%) were intrasinus-type, 30 (15%) were calvarial-type, and 1 (1%) was mixed-type; the specific location was recorded in 182 (93%); clinical history was available for 92 (47%); imaging data were available in 140 (72%); and histologic data were available in 52 (27%) [ 3 , 9 , 10 , 13 , 14 , 15 , 16 ]. Sex was available for 147 of 169 persons (87%) [ 3 , 10 , 13 , 14 , 15 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 164 (84%) were intrasinus-type, 30 (15%) were calvarial-type, and 1 (1%) was mixed-type; the specific location was recorded in 182 (93%); clinical history was available for 92 (47%); imaging data were available in 140 (72%); and histologic data were available in 52 (27%) [ 3 , 9 , 10 , 13 , 14 , 15 , 16 ]. Sex was available for 147 of 169 persons (87%) [ 3 , 10 , 13 , 14 , 15 , 16 ]. Among the GAG cases with histology, 14 presented at surgery [ 3 , 12 , 13 , 14 , 15 , 16 , 45 ], and 27 presented at autopsy [ 9 , 10 ].…”

Section: Resultsmentioning

confidence: 99%

“…Sex was available for 147 of 169 persons (87%) [ 3 , 10 , 13 , 14 , 15 , 16 ]. Among the GAG cases with histology, 14 presented at surgery [ 3 , 12 , 13 , 14 , 15 , 16 , 45 ], and 27 presented at autopsy [ 9 , 10 ]. Patients with GAGs exhibited variable demographic and GAG characteristics, as summarized in Table 1 and Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Giant Arachnoid Granulations: A Systematic Literature Review

Mehta,

Mehta

2023

IJMS

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Giant arachnoid granulations (GAGs) are minimally investigated. Here, we systematically review the available data in published reports to better understand their etiologies, nomenclature, and clinical significance. In the literature, 195 GAGs have been documented in 169 persons of varied ages (range, 0.33 to 91 years; mean, 43 ± 20 years; 54% female). Prior reports depict intrasinus (i.e., dural venous sinus, DVS) (84%), extrasinus (i.e., diploic or calvarial) (15%), and mixed (1%) GAG types that exhibit pedunculated, sessile, or vermiform morphologies. GAG size ranged from 0.4 to 6 cm in maximum dimension (mean, 1.9 ± 1.1 cm) and encompassed symptomatic or non-symptomatic enlarged arachnoid granulations (≥1 cm) as well as symptomatic subcentimeter arachnoid granulations. A significant difference was identified in mean GAG size between sex (females, 1.78 cm; males, 3.39 cm; p < 0.05). The signs and symptoms associated with GAGs varied and include headache (19%), sensory change(s) (11%), and intracranial hypertension (2%), among diverse and potentially serious sequelae. Notably, brain herniation was present within 38 GAGs (22%). Among treated individuals, subsets were managed medically (19 persons, 11%), surgically (15 persons, 9%), and/or by endovascular DVS stenting (7 persons, 4%). Histologic workup of 53 (27%) GAG cases depicted internal inflammation (3%), cystic change consistent with fluid accumulation (2%), venous thrombosis (1%), hemorrhage (1%), meningothelial hyperplasia (1%), lymphatic vascular proliferation (1%), and lymphatic vessel obliteration (1%). This review emphasizes heterogeneity in GAG subtypes, morphology, composite, location, symptomatology, and imaging presentations. Additional systematic investigations are needed to better elucidate the pathobiology, clinical effects, and optimal diagnostic and management strategies for enlarged and symptomatic arachnoid granulation subtypes, as different strategies and size thresholds are likely applicable for medical, interventional, and/or surgical treatment of these structures in distinct brain locations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Giant Arachnoid Granulations: A Systematic Literature Review

Mehta,

Mehta

2023

IJMS

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“…Any specimens demonstrating pathological processes that may mimic or alter the appearance of arachnoid foveae were excluded from the sample. This was not a problem however, as the foveae formed by arachnoid granulations are easily differentiated from other skull markings because of their parasagittal location (11,12). It is uncommon for arachnoid granulations to become unusually large producing calvarial defects that simulate other lesions (13,14).…”

Section: Methodsmentioning

confidence: 99%

A Quantitative Method for Estimation of Volume Changes in Arachnoid Foveae with Age

Duray

Martel

2006

Journal of Forensic Sciences

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Age-related changes of arachnoid foveae have been described, but objective, quantitative analyses are lacking. A new quantitative method is presented for estimation of change in total volume of arachnoid foveae with age. The pilot sample consisted of nine skulls from the Palmer Anatomy Laboratory. Arachnoid foveae were filled with sand, which was extracted using a vacuum pump. Mass was determined with an analytical balance and converted to volume. A reliability analysis was performed using intraclass correlation coefficients. The method was found to be highly reliable (intraobserver ICC = 0.9935, interobserver ICC = 0.9878). The relationship between total volume and age was then examined in a sample of 63 males of accurately known age from the Hamann-Todd collection. Linear regression analysis revealed no statistically significant relationship between total volume and age, or foveae frequency and age (alpha = 0.05). Development of arachnoid foveae may be influenced by health factors, which could limit its usefulness in aging.

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An asymptomatic hypertrophic pacchionian granulation simulating osteolytic lesion of the calvaria

Celli

Cervoni

Quasho

1999

Neurosurgical Review

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Osteolytic lesions can be seen in various diseases. We present a rare case of symptomatic hypertrophic pacchionian granulation mimicking bone tumor in the calvaria. A 50-year-old woman suffered from a previous VII cranial nerve peripheral paresis accompanied by headache. A plain radiograph revealed a punched-out paramedial occipital lesion. Precontrast-enhanced computed tomographic scans demonstrated a hypodense mass, with a defect of both tables of the left occipital bone. Magnetic resonance imaging (MRI) demonstrated a hypointense mass on the T1-weighted image and isointense to cerebrospinal fluid on the T2-weighted image, with capsule-like contrast enhancement by gadolinium. A biopsy was performed. Histologically, hypertrophic pacchionian granulation was diagnosed. The patient has had no growth for 2 years. This case suggests the need to include hypertrophic pacchionian granulation in the differential diagnosis of punched-out lesions.

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Protruding arachnoid granulations mimicking dermoid cysts

Cited by 14 publications

References 1 publication

Giant Arachnoid Granulations: A Systematic Literature Review

Giant Arachnoid Granulations: A Systematic Literature Review

A Quantitative Method for Estimation of Volume Changes in Arachnoid Foveae with Age

An asymptomatic hypertrophic pacchionian granulation simulating osteolytic lesion of the calvaria

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