Symptomatic Arachnoid Cyst after Minor Head Trauma: Conservative Approach’s Controversy

Inês Rosinha, Helena Rios, Joana Pinto, Filipa Rodrigues and José G Soares

Department of Pediatrics, Baixo Vouga Hospital Center, Portugal Department of Neuroradiology, Coimbra Hospital and University Center, Portugal Department of Neurosurgery, Coimbra Hospital and University Center, Portugal

^*Correspondance to: Inês Mendonça de Oliveira Rosinha 

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Abstract:

Arachnoid cysts are benign congenital extra-axial malformations filled with cerebrospinal fluid, but not communicating with the ventricular system. Most are asymptomatic, usually found incidentally in neuroimaging studies. A two-year-old boy was referred for intermittent frontal headache that arose after falling from his own height the day before, with phonophobia, photophobia and triggered by exertion/defecation, and associated with a single postprandial vomiting. There were no visual complaints and no focal deficits on neurological examination. Neuroimaging studies revealed a left frontotemporal cystic lesion of 82 mm × 52 mm × 77 mm, compressing insula and adjacent structures, and a bilateral subdural hygroma of probable posttraumatic etiology. He remained in hospital surveillance, maintaining hemodynamic stability and progressive clinical improvement; thereupon he was discharged and forwarded to Neurosurgery Consultation. Despite conventional neurosurgical treatment recommendation, newer reports suggest a promising role for the conservative approach, even in voluminous symptomatic lesions. This clinical case comes to corroborate the most recent evidence. 

Keywords:

Arachnoid cysts; Subdural hygroma; Middle temporal fossa; Cerebrospinal fluid; Neuroimaging studies; Conservative/surgical treatment

Cite the Article:

Rosinha I, Rios H, Pinto J, Rodrigues F, Soares JG. Symptomatic Arachnoid Cyst after Minor Head Trauma: Conservative Approach’s Controversy. Clin Case Rep Int. 2020; 4: 1199..