What provokes a disappearing arachnoid cyst? – Case study and literature review

Gaelle, Haddad; Alam, Raquelle; Ann, Atweh Lamya; Mukbil, Hourani

doi:10.1016/j.clinimag.2021.11.001

Cited by 5 publications

(8 citation statements)

References 39 publications

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“…Meanwhile, 33 of those cases had no clear mechanism for resorption. [4] As there are no treatment guidelines for incidentally discovered AC in adults, understanding the mechanisms of morphologic changes in AC after head trauma would be essential in establishing an appropriate treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resorption of a convexity arachnoid cyst associated with intracystic hemorrhage and subdural hematoma: A case report

Hanai

Yanaka

Aiyama

et al. 2023

Surgical Neurology International

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Background: Intracranial arachnoid cysts (ACs) are developmental anomalies usually filled with cerebrospinal fluid (CSF), rarely resolving throughout life. Here, we present a case of an AC with intracystic hemorrhage and subdural hematoma (SDH) that developed after a minor head injury before gradually disappearing. Neuroimaging demonstrated specific changes from hematoma formation to AC disappearance over time. The mechanisms of this condition are discussed based on imaging data. Case Description: An 18-year-old man was admitted to our hospital with a head injury caused by a traffic accident. On arrival, he was conscious with a mild headache. Computed tomography (CT) revealed no intracranial hemorrhages or skull fractures but an AC was seen in the left convexity. One month later, follow-up CT scans showed an intracystic hemorrhage. Subsequently, an SDH appeared then both the intracystic hemorrhage and SDH gradually shrank, with the AC disappearing spontaneously. The AC was considered to have disappeared, along with the spontaneous SDH resorption. Conclusion: We present a rare case where neuroimaging demonstrated spontaneous resorption of an AC combined with intracystic hemorrhage and SDH over time, which may provide new insights into the nature of adult ACs.

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Section: Discussionmentioning

confidence: 99%

Spontaneous resorption of a convexity arachnoid cyst associated with intracystic hemorrhage and subdural hematoma: A case report

Hanai

Yanaka

Aiyama

et al. 2023

Surgical Neurology International

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“…The rhexis of the small vessels surrounding the cyst could account for the purely intracystic bleeding after the rupture, while the simultaneous cyst rupture and bridging vein tears would justify the association between subdural collection and intracystic hemorrhage; 5) SAC disappearance after head injury is a rare but not exceptional phenomenon. The advocated mechanisms for such an event are related to traumatic fenestration of the cyst into the subarachnoid cisterns and/or posttraumatic drainage of the cyst into the subdural space [ 140 ]. The brain re-expansion is a necessary requisite for the cyst effacement/reduction in seize; indeed, the cyst disappearance is usually found in young patients.…”

Section: Discussionmentioning

confidence: 99%

“…Sometimes, indeed, the collection (mainly, hygroma) tends to remain relatively thin and not to produce relevant symptoms, so that it is possible to wait for its spontaneous re-adsorption. This phenomenon would explain also the rare disappearance of the cyst after the rupture, due to the drainage into the subarachnoid spaces [ 30 , 134 , 140 ]. Some authors experienced the successful use of acetazolamide for promoting the re-adsorption of the subdural hygroma [ 39 , 131 ].…”

Section: Discussionmentioning

confidence: 99%

Ruptured Sylvian arachnoid cysts: an update on a real problem

et al. 2022

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Purpose Sylvian arachnoid cysts (SACs) are the most common type of arachnoid cysts and the most prone to undergo a rupture. This event is considered rare but potentially severe. No definite information is available on its occurrence or management. The goal of the present article is to provide an update on the epidemiological, etiological, and clinical aspects and the management of this peculiar clinical condition. Methods A comprehensive review of the English literature of the last 40 years on this topic has been realized. Moreover, a personal series of children investigated and treated in the last 20 years is presented. These patients were managed as follows: (1) treatment of the subdural collection; (2) identification of candidates for surgical treatment of the residual cyst (brain MRI, perfusion brain MRI, prolonged invasive ICP monitoring (selected cases), EEG, neuropsychological tests); (3) surgical treatment of the cyst in the patients with pathological perfusion MRI and/or ICP measurement and/or clear neurophysiological and neuropsychological correlations. Results A total of 446 patients (430 from the literature and 16 from the personal series), mainly children, adolescents, and young adults, have been analyzed leading to the following results: (1) SAC rupture is rare but not negligible (yearly risk of rupture: 0.04%; overall risk up to 10% in children affected by SCAs). Prophylactic surgery in asymptomatic cases is not advisable. (2) The mechanism of rupture is not known but an impact of SAC against the sphenoid wing and/or a direct injury on SAC through a thinned temporal bone, with possible laceration of the cyst wall vessels and/or tear of the bridging veins, can be hypothesized. A head injury is often not reported (may be misdiagnosed). (3) Subdural collection (hygroma > chronic hematoma) is the most common finding followed by intracystic bleeding, extradural hematoma, and other types of bleeding. Signs or symptoms of raised intracranial pressure are the most frequent ones. (4) The complication of the rupture is usually treated in emergency or in the acute period by burr hole or craniotomic evacuation of the subdural collection, although a conservative management is possible in some cases. Following the rupture, the majority of SACs are treated (70%), often at the same time of the complication, but no specific investigations are routinely performed to select candidates. According to our protocol, only 43.7% of SACs needed to be treated. Conclusions The “spontaneous” or posttraumatic rupture of SACs is a rare but potentially significant complication followed by a generally good outcome. The course of the cyst is independent from the outcome of the complication, consequently requiring specific investigations for individuating those lesions interfering with CSF dynamics and/or cerebral blood flow.

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“…Spontaneous resolution of an AC may be triggered by irrelevant intracranial procedure that disturbs cerebrospinal fluid flow, as well as osmotic gradient changes after infection or post-traumatic subdural hemorrhage. 2 A minor head injury can also lead to cyst wall tear, resulting in progressive drainage and cyst disappearance. Haddad et al reviewed cases of spontaneously disappearing ACs before 2021 and found that 55.9% of ACs regressed without a known cause.…”

mentioning

confidence: 99%

“…Haddad et al reviewed cases of spontaneously disappearing ACs before 2021 and found that 55.9% of ACs regressed without a known cause. 2 The proposed mechanism in patients without head trauma or intracranial events involves a sudden transient increase in intracranial pressure, for example, Valsalva maneuver, which causes the cyst wall to breach.…”

mentioning

confidence: 99%

Spontaneous resolution of a symptomatic cerebellopontine angle arachnoid cyst in adult: A case report and literature review

Chen,

Chao,

Tai

et al. 2023

The Kaohsiung J of Med Scie

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Arachnoid cysts (ACs) account for 1% of all intracranial masses, and majority of cases are asymptomatic. 1 In adult, symptomatic AC often requires surgical intervention, with spontaneous resolution being a rare occurrence. Here, we present the first documented case of spontaneous resolution of a symptomatic cerebellopontine angle (CPA) AC in adult, with subsequent recovery of neurological deficits.

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What provokes a disappearing arachnoid cyst? – Case study and literature review

Cited by 5 publications

References 39 publications

Spontaneous resorption of a convexity arachnoid cyst associated with intracystic hemorrhage and subdural hematoma: A case report

Spontaneous resorption of a convexity arachnoid cyst associated with intracystic hemorrhage and subdural hematoma: A case report

Ruptured Sylvian arachnoid cysts: an update on a real problem

Spontaneous resolution of a symptomatic cerebellopontine angle arachnoid cyst in adult: A case report and literature review

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