An 11-year-old girl was brought to the emergency department with a complaint of a progressive headache that was associated with vomiting. On examination, she was found to have papilledema. Subsequently, magnetic resonance imaging of the brain was performed to exclude any space-occupying lesion. The scan demonstrated a right extra-axial temporal lesion, measuring 7.8 x 5.4 x 4.9 cm on maximum dimensions, along with an extension to the right cerebral convexity in a crescentic shape. The lesion follows the signal intensity of cerebrospinal fluid on all sequences and exhibited no post-contrast enhancement or restricted diffusion. The lesion exerted a mass effect in the form of compression of the right temporal lobe. These findings were consistent with an arachnoid cyst with subdural hygroma. The patient was referred to the neurosurgery team. Then, the right temporal arachnoid cyst was drained through the right temporal craniotomy and the subdural hygroma was drained through a frontal Burr hole. The patient was seen after one month in the pediatrics clinic and was completely asymptomatic 1)
1: Mao X, Xu L, Liu W, Hao S, Liu B. Local Skull Thinning is One of Risks for the Ruptured Arachnoid Cysts With Chronic Subdural Hematoma in Adults: Thirty- two Clinical Reports. J Craniofac Surg. 2022 Mar-Apr 01;33(2):e102-e105. doi: 10.1097/SCS.0000000000007957. PMID: 34260457.
2: Szczygielski J, München D, Ketter R, Ràkàsz L, Schulz-Schaeffer W, Oertel J. Head Injury without Head Blow? A Rare Case of Subdural Hematoma Associated with Minute Arachnoid Cyst in a Teenage Skater. J Neurol Surg A Cent Eur Neurosurg. 2021 Nov;82(6):604-610. doi: 10.1055/s-0040-1721021. Epub 2021 Feb 4. PMID: 33540449.
3: Bryden A, Majors N, Puri V, Moriarty T. A Rare Case of Spontaneous Arachnoid Cyst Rupture Presenting as Right Hemiplegia and Expressive Aphasia in a Pediatric Patient. Children (Basel). 2021 Jan 24;8(2):78. doi: 10.3390/children8020078. PMID: 33498812; PMCID: PMC7911169.
4: García-Pérez D, Panero I, Paredes I. Positive outcome after endoscopic treatment of a symptomatic convexity arachnoid cyst in an elderly. Br J Neurosurg. 2021 Jan 19:1-2. doi: 10.1080/02688697.2021.1872774. Epub ahead of print. PMID: 33464128.
5: Watanabe T, Sugawara T, Inaji M, Tanaka Y, Nariai T, Tazawa T, Maehara T. [Remarkable Recovery of Chronic Symptoms in an Adult with Middle Fossa Convexity Arachnoid Cyst after Cystoventriculostomy:A Case Report]. No Shinkei Geka. 2020 Nov;48(11):1059-1065. Japanese. doi: 10.11477/mf.1436204320. PMID: 33199664.
6: Kimura R, Hayashi Y, Sasagawa Y, Kobayashi M, Oishi M, Kinoshita M, Nakada M. Progressively Enlarged Convexity Arachnoid Cysts in Elderly Patients: A Report of 2 Cases. World Neurosurg. 2020 Mar;135:253-258. doi: 10.1016/j.wneu.2019.12.112. Epub 2019 Dec 27. PMID: 31887463.
7: Kim DU, Park HR, Chang JC, Park SQ, Cho SJ, Park HK. Disappearance of Arachnoid Cyst after Burrhole Trephination: Case Series. Korean J Neurotrauma. 2019 Aug 28;15(2):170-175. doi: 10.13004/kjnt.2019.15.e18. PMID: 31720272; PMCID: PMC6826094.
8: Nagata K, Kiyofuji S, Yokoyama M, Sora S. Resection of a lateral supratentorial endodermal cyst complicated by postoperative seizures: A case report. Surg Neurol Int. 2019 Jul 19;10:141. doi: 10.25259/SNI_259_2019. PMID: 31528476; PMCID: PMC6744738.
9: Diaz-Romero Paz R, Avendaño Altimira P, Coloma Valverde G, Balhen Martin C. A Rare Case of Negative-Pressure Hydrocephalus: A Plausible Explanation and the Role of Transmantle Theory. World Neurosurg. 2019 May;125:6-9. doi: 10.1016/j.wneu.2019.01.117. Epub 2019 Jan 31. PMID: 30710718.
10: Schul DB, Meier MP, Földvari Z, Krammer MJ, Lumenta CB. Rare Case of Convexity Meningioma Growing into Arachnoid Cyst. World Neurosurg. 2018 Sep;117:199-202. doi: 10.1016/j.wneu.2018.06.040. Epub 2018 Jun 15. PMID: 29913293.
11: Wu X, Li G, Zhao J, Zhu X, Zhang Y, Hou K. Arachnoid Cyst-Associated Chronic Subdural Hematoma: Report of 14 Cases and a Systematic Literature Review. World Neurosurg. 2018 Jan;109:e118-e130. doi: 10.1016/j.wneu.2017.09.115. Epub 2017 Sep 28. PMID: 28962953.
12: Wang C, Han G, You C, Liu C, Wang J, Xiong Y. Individual surgical treatment of intracranial arachnoid cyst in pediatric patients. Neurol India. 2013 Jul- Aug;61(4):400-5. doi: 10.4103/0028-3886.117618. PMID: 24005732.
13: Gui S, Zong X, Li C, Zhang Y. Endoscopic treatment of convexity arachnoid cysts. Childs Nerv Syst. 2013 Mar;29(3):505-8. doi: 10.1007/s00381-012-1957-8. Epub 2012 Nov 14. PMID: 23149590.
14: Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. 2013 Feb;118(2):222-31. doi: 10.3171/2012.10.JNS12548. Epub 2012 Nov 9. PMID: 23140149.
15: Zhang B, Zhang Y, Ma Z. Long-term results of cystoperitoneal shunt placement for the treatment of arachnoid cysts in children. J Neurosurg Pediatr. 2012 Oct;10(4):302-5. doi: 10.3171/2012.7.PEDS11540. Epub 2012 Aug 17. PMID: 22900484.
16: Seddighi A, Seddighi AS, Zali AR, Baqdashti HR. Presentation of a minimally symptomatic large extradural hematoma in a patient with an arachnoid cyst: a case report and review of the literature. J Med Case Rep. 2011 Dec 19;5:581. doi: 10.1186/1752-1947-5-581. PMID: 22182235; PMCID: PMC3339374.
17: Alexiou GA, Varela M, Sfakianos G, Prodromou N. Shunting for the treatment of arachnoid cysts in children. Neurosurgery. 2010 Dec;67(6):1632-6; discussion 1636. doi: 10.1227/NEU.0b013e3181f94476. PMID: 21107193.
18: Helland CA, Lund-Johansen M, Wester K. Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample. J Neurosurg. 2010 Nov;113(5):934-9. doi: 10.3171/2009.11.JNS081663. Epub 2010 Jan 22. PMID: 20095787.
19: Suzuki M, Tamaki T, Toda S, Tsuchiya M, Kogure K, Hosone M, Node Y, Teramoto A. Delayed recurrent arachnoid cyst of the occipital convexity in an elderly woman. Neurol Med Chir (Tokyo). 2009 Mar;49(3):134-7. doi: 10.2176/nmc.49.134. PMID: 19318741.
20: Marshman LA, David KM, King A, Chawda SJ. Delayed fibrotic obliteration of the spinal subarachnoid space after cerebral aneurysmal subarachnoid hemorrhage: case report. Neurosurgery. 2007 Sep;61(3):E659-60; discussion E660. doi: 10.1227/01.NEU.0000290920.55470.EC. PMID: 17881943.
21: Kushen MC, Frim D. Placement of subdural electrode grids for seizure focus localization in patients with a large arachnoid cyst. Technical note. Neurosurg Focus. 2007 Feb 15;22(2):E5. doi: 10.3171/foc.2007.22.2.5. PMID: 17608348.
22: Yagi T, Ohashi Y, Nakano S, Ogawa M, Fukamachi A. [A case of symptomatic arachnoid cyst of the occipital convexity in an adult]. No Shinkei Geka. 2006 Nov;34(11):1125-9. Japanese. PMID: 17087267.
23: Tucker A, Miyake H, Omura T, Tsuji M, Ukita T, Nishihara K, Oi S. Huge arachnoid cyst of the occipital cerebral convexity. Neurol Med Chir (Tokyo). 2006 Jul;46(7):361-5. doi: 10.2176/nmc.46.361. PMID: 16861832.
24: Helland CA, Wester K. Arachnoid cysts in adults: long-term follow-up of patients treated with internal shunts to the subdural compartment. Surg Neurol. 2006 Jul;66(1):56-61; discussion 61. doi: 10.1016/j.surneu.2005.12.032. PMID: 16793443.
25: Chernov MF, Kamikawa S, Yamane F, Hori T. Double-endoscopic approach for management of convexity arachnoid cyst: case report. Surg Neurol. 2004 May;61(5):483-6; discussion 486-7. doi: 10.1016/S0090-3019(03)00574-3. PMID: 15120233.
26: Cokluk C, Senel A, Celik F, Ergür H. Spontaneous disappearance of two asymptomatic arachnoid cysts in two different locations. Minim Invasive Neurosurg. 2003 Apr;46(2):110-2. doi: 10.1055/s-2003-39337. PMID: 12761683.
27: Weber J, Gassel AM, Hoch A, Kilisek L, Spring A. Intraoperative management of cystic meningiomas. Neurosurg Rev. 2003 Jan;26(1):62-6. doi: 10.1007/s10143-002-0228-7. Epub 2002 Jun 11. PMID: 12520319.
28: Mori K, Yamamoto T, Horinaka N, Maeda M. Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles: twelve cases of chronic subdural hematoma associated with arachnoid cyst. J Neurotrauma. 2002 Sep;19(9):1017-27. doi: 10.1089/089771502760341938. PMID: 12482115.
29: Galarza M, Pomata HB, Pueyrredón F, Bartuluchi M, Zuccaro GN, Monges JA. Symptomatic supratentorial arachnoid cysts in children. Pediatr Neurol. 2002 Sep;27(3):180-5. doi: 10.1016/s0887-8994(02)00414-9. PMID: 12393127.
30: Ulmer S, Engellandt K, Stiller U, Nabavi A, Jansen O, Mehdorn MH. Chronic subdural hemorrhage into a giant arachnoidal cyst (Galassi classification type III). J Comput Assist Tomogr. 2002 Jul-Aug;26(4):647-53. doi: 10.1097/00004728-200207000-00031. PMID: 12218836.
31: Hayashi Y, Futami K, Munemoto S, Hamada Y, Soma M, Yamashita J, Hasegawa M. Congenital arachnoid cyst mimicking meningocele. Pediatr Neurosurg. 2002 Jun;36(6):324-8. doi: 10.1159/000063537. PMID: 12077478.
32: Tamiya T, Ono Y, Matsumoto K, Ohmoto T. Peritumoral brain edema in intracranial meningiomas: effects of radiological and histological factors. Neurosurgery. 2001 Nov;49(5):1046-51; discussion 1051-2. doi: 10.1097/00006123-200111000-00003. PMID: 11846896.
33: Utsunomiya A, Narita N, Jokura H. [Treatment of symptomatic convexity arachnoid cyst in the elderly by neuroendoscope assisted-stereotactic surgery: a case report]. No To Shinkei. 2001 Nov;53(11):1039-42. Japanese. PMID: 11761913.
34: Motohashi O, Kameyama M, Imaizumi S, Mino M, Naganuma H, Onuma T. [An epithelial cyst at the frontal convexity]. No Shinkei Geka. 2001 Sep;29(9):857-62. Japanese. PMID: 11596470.
35: Thompson TP, Levy EI, Jho HD, Lunsford LD. Primum non nocere: Multimodality management strategies when multiple mass lesions strike a single patient. Surg Neurol. 2001 Jun;55(6):332-9. doi: 10.1016/s0090-3019(01)00458-x. PMID: 11483187.
36: Tsurushima H, Harakuni T, Saito A, Tominaga D, Hyodo A, Yoshii Y. Symptomatic arachnoid cyst of the left frontal convexity presenting with memory disturbance–case report. Neurol Med Chir (Tokyo). 2000 Jun;40(6):339-41. doi: 10.2176/nmc.40.339. PMID: 10892273.
37: Rizk T, Samaha E, Nohra G, Maarrawi J, Okais N. Fracture évolutive du toit de l'orbite [Growing fracture of the orbital roof. A case report]. Neurochirurgie. 1999 Dec;45(5):422-5. French. PMID: 10717595.
38: Kim MH. The role of endoscopic fenestration procedures for cerebral arachnoid cysts. J Korean Med Sci. 1999 Aug;14(4):443-7. doi: 10.3346/jkms.1999.14.4.443. PMID: 10485626; PMCID: PMC3054399.
39: Yan HJ, Lin KE, Lee ST, Tzaan WC. Calcified chronic subdural hematoma: case report. Changgeng Yi Xue Za Zhi. 1998 Dec;21(4):521-5. PMID: 10074745.
40: Asahi T, Endo S, Akai T, Takaba M, Takaku A. Nontraumatic convexity intradiploic arachnoid cyst. Neurol Med Chir (Tokyo). 1998 Jun;38(6):374-6. doi: 10.2176/nmc.38.374. PMID: 9689824.
41: Vassilyadi M, Farmer JP, Montes JL. Negative-pressure hydrocephalus. J Neurosurg. 1995 Sep;83(3):486-90. doi: 10.3171/jns.1995.83.3.0486. PMID: 7666227.
42: Okura A, Noguchi S, Yuge T, Maruiwa H, Matsunaga M, Shigemori M. [A case of convexity arachnoid cyst associated with chronic subdural hematoma and intracystic hemorrhage]. No Shinkei Geka. 1994 Mar;22(3):273-7. Japanese. PMID: 8133971.
43: Behrens P, Ostertag CB. Zystische Fehlbildungen des Gehirns: Stereotaktische Diagnostik und Therapie [Cystic abnormalities of the brain: stereotaxic diagnosis and therapy]. Nervenarzt. 1992 Dec;63(12):725-30. German. PMID: 1494386.
44: Pomeranz S, Constantini S, Lubetzki-Korn I, Amir N. Familial intracranial arachnoid cysts. Childs Nerv Syst. 1991 Apr;7(2):100-2. doi: 10.1007/BF00247865. PMID: 1863926.