Investig Magn Reson Imaging.  2016 Jun;20(2):120-122. 10.13104/imri.2016.20.2.120.

Nontraumatic Intracystic Hemorrhage of Arachnoid Cyst: CT and MR Findings

• Kim SJ
• Baek HJ
• Moon JI
• Cho SB
• Choi BH
• Bae K
• Jeon KN
• Choi DS

• KMID: 2327424
• DOI: http://doi.org/10.13104/imri.2016.20.2.120

Abstract

Arachnoid cysts (AC) are intraarachnoidal cerebrospinal fluid collections, and account for 1% of all intracranial space-occupying lesions. Intracystic hemorrhage of the AC can occur spontaneously, but this is an extremely rare event. Herein, we present a case of hemorrhagic AC in a nontraumatic patient in the left middle cranial fossa. We also performed relevant literature review on this disease.

Keyword

Arachnoid cyst; Computed tomography; Magnetic resonance imaging; Hemorrhage; Rupture

MeSH Terms

Arachnoid Cysts
Arachnoid*
Cerebrospinal Fluid
Cranial Fossa, Middle
Hemorrhage*
Humans
Magnetic Resonance Imaging
Rupture

Figure

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  Fig. 1 A 22-year-old man presented with acute onset severe headache and vomiting. Initial non-enhanced (a) and enhanced (b) brain CT images reveal a hyperdense extraaxial mass in the left middle cranial fossa, suggesting acute hematoma. Intracranial CT angiography (c) shows an upward displacement of the left middle cerebral artery and its branches by the extraaxial hematoma (arrows). And there is no significant vascular derangement in the major intracranial arteries.

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  Fig. 2 On follow-up MR imaging after 8 days postoperatively, the intracystic hemorrhage shows a complete resolution on T1-weighted image (a) and T2-weighted image (b). Although cyst fenestration was performed during surgery, residual arachnoid cyst is still noted in the left middle cranial fossa. MR images also reveal small amount of resolving postoperative subdural hemorrhage (early subacute stage) in the left anterior temporal and bilateral occipital convexities.

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