Investig Magn Reson Imaging.  2017 Sep;21(3):192-194. 10.13104/imri.2017.21.3.192.

Giant Arachnoid Granulations in Headache Mimicking Migraine with Aura

• Park JE
• Lee EJ

• KMID: 2392692
• DOI: http://doi.org/10.13104/imri.2017.21.3.192

Abstract

Giant arachnoid granulations have been reported to be associated with headaches, which can be acute or chronic in presentation. In some cases, idiopathic intracranial hypertension, previously called pseudotumor cerebri, may occur. The pathophysiology of these enlarged structures seen as filling defects on imaging is not clearly defined, although they are presumed to cause symptoms such as headache via pressure resulting from secondary venous sinus obstruction. We present a unique presentation of secondary headache in a 39-year-old man with no prior history of headaches found to have giant arachnoid granulations, presenting as migraine with aura.

Keyword

Arachnoid; Granulation; Headache; Migraine; Aura

MeSH Terms

Adult
Arachnoid*
Epilepsy
Headache*
Humans
Migraine Disorders*
Migraine with Aura*
Pseudotumor Cerebri

Figure

• 

  Fig. 1 (a) Coronal T2-weighted image. Multifocal amorphous hyperintense lesions compressing the superior sagittal sinus are seen (black arrows). Tubular hyperintense lesion (short black arrow) in the right superficial cortical vein is also seen. (b) Coronal T1-weighted image. Hypointense lesions (black arrows) are noted. (c) Contrast-enhanced MR venography. Irregular narrowing or the lumen and multifocal filling defects in the superior sagittal sinuses (long white arrows) as well as the right superficial cortical vein (short white arrow) are noted. (d) Coronal source imaging of MR venography. There are poorly opacified lesions (white arrows) compressing the superior sagittal sinus. Filling defects (white arrow) in the right superficial cortical vein are seen.

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