Spontaneous Intracystic Hemorrhage of the Arachnoid Cyst: A Case Report and Review of Literature

Abstract

Arachnoid cysts represent benign cysts that occur in the cerebrospinal axis in relation to the arachnoidmembrane and do not communicate with the ventricular system. We report a case of a years righthanded lady, who presented to the emergency department with the complaints of headache andvomiting for one week CT scan showed extraaxial cystic lesion in the left fronto-parietal region.On the fifth day of admission, patient had sudden onset of severe headache associated with loss ofconsciousness for about 3-4 minutes with neck rigidity.A CT scan of head was repeated, which showed left fronto-parietal cystic lesion with intracystic bleedand SAH. Intraoperatively, there was intradural cystic lesion containing xanthochromic fluid withnormal brain surface and there were no evidence of any vascular malformations. Marsupilizationof the cystic lesion was carried out and she improved. The literature regarding arachnoid cyst withspontaneous intracranial haemorrhage is reviewed.Key word: arachnoid cyst, haemorrhage, intracycstic

Unusual Cause for Unilateral Headache: A Quadrigeminal Cistern Arachnoid Cyst

“…Most of them are asymptomatic or are presented with seizures, focal defi cit, normal pressure hydrocephalus, lower cranial nerve pareses, bleeding into the cyst or trigeminal neuralgia. [3][4][5][6] Various factors like distortion of the pons with stretching of the trigeminal nerve, irregular demyelination within the root entry zone, or contact between the root entry zone and a vascular structure is the cause for pain. 3,6 Management of symptomatic cysts include surgery, either fenestration, cystoperitoneal shunt, excision or endoscopically fenestration or excision.…”

“…3,6 Management of symptomatic cysts include surgery, either fenestration, cystoperitoneal shunt, excision or endoscopically fenestration or excision. 5,7 Open surgery and endoscopic methods have both been proven to be effective in treating these cysts. In cases where the patients are unfi t or who refuse surgery, medical management can help free patients from symptoms but it must be started early to prevent morbidity.…”