Abstract

Case Report

Chronic subdural haematoma associated with arachnoid cyst of the middle fossa in a soccer player: Case report and review of the literature

Elena Beretta*, Michele Incerti, Giuseppe Raudino, Gaspare F Montemagno and Franco Servadei

Published: 16 May, 2020 | Volume 4 - Issue 1 | Pages: 032-037

Introduction: Arachnoid cyst (AC) is a congenital, benign, extra-axial lesion often found incidentally on intracranial imaging and makes up almost 1% of all intracranial masses. It arises from the splitting of arachnoid membranes with components similar to the cerebrospinal fluid. It’s reported that AC can be complicated by chronic subdural haematoma in athletes with repeated head injuries.

Case report: we describe a case of a soccer player with an AC that underwent surgery for a chronic subdural haematoma with full recovery.

Material and method: From a PubMed research, we found 14 relevant studies reporting a total of 15 patients who met the inclusion criteria: playing soccer, subdural hematoma and arachnoid cyst.

Results: Patients underwent different surgical treatment. In the case of hygroma with no midline shift, a conservative treatment was performed. In all cases the reported follow up was a full recovery.

Discussion: Soccer is not usually considered a contact sport related to a high risk of head trauma or shaking head. From our review we can postulate that a soccer player with AC has an augmented risk to have a subdural haemorrhage, more rarely intracerebral haemorrhage.

Conclusion: ACs are common meningeal abnormalities. They may bleed after minor head trauma, although it is rare. Asymptomatic patients with known AC should be monitored by a neurosurgeon and decision to engage this patient in soccer sport participation is still controversial.

Read Full Article HTML DOI: 10.29328/journal.acr.1001037 Cite this Article Read Full Article PDF

Keywords:

Arachnoid cyst; Head trauma; Soccer player; Chronic subdural hematoma; Sports trauma

References

  1. Galassi E, Pazza G, Gaist G, Giuliani G, Pozzati E. Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically. Acta Neurochir Suppl (Wien) 1988; 42: 201-204. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3189009
  2. Heier LA, Zimmermann RD, Amster JL, Gandy SE, Deck MD. Magnetic resonance imaging of arachnoid cyst. Clin Imaging 1989; 13:281-291. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2598110
  3. Wester K. Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients. Neurosurgery. 1999; 45: 775-779. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10515470
  4. Lee KS. Natural history of chronic subdural hematomas: a review. J Neurosurg. 2004; 18:351-358. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/14742149
  5. Miele VJ, Bailes JE, Martin NA. Participation in contact or collision sports in athletes with epilepsy, genetic risk factors, structural brain lesions, or history of craniotomy. Neurosurg Focus. 2006; 21: E9. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17112199
  6. Galassi E, Tognetti F, Gaist G, Fagioli L, Frank F, et al. CT scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: classification and pathophysiological aspects. Surg Neurol. 1982; 17: 363-369. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7089853
  7. Oliver L. C. Primary arachnoid cysts; report of two cases. Br Med J. 1958; 1:1147-1149. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/13536443
  8. Maeda M, Kawamura Y, Handa Y, Kubota T, Ishii Y. Value of MR imaging in middle fossa arachnoid cyst with intracystic and subdural hematoma. Eur J Radiol. 1993; 17: 145-147. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8293737
  9. Kawanishi A, Nakayama M, Kadota K. Heading injury precipitating subdural hematoma associated with arachnoid cysts-two case reports. Neurol Med Chir (Tokyo). 1999; 39: 231-233. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10344112
  10. Chillala S, Read C, Evans PA. An unusual case of subdural haematoma presenting to the accident and emergency department. Emerg Med J. 2001; 18: 308-309. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11435376
  11. Prabhu VC, Bailes JE. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report. Neurosurgery. 2002; 50:195-197. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11844251
  12. Demetriades AK, McEvoy AW, Kitchen ND. Subdural haematoma associated with an arachnoid cyst after repetitive minor heading injury in ball games. Br J Sports Med. 2004; 38: E8. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15273201
  13. Offiah C, St Clair Forbes W, Thorne J. Non-haemorrhagic subdural collection complicating rupture of a middle cranial fossa arachnoid cyst. Br J Radiol. 2006; 79:79–82. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16421410
  14. Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: neuroradiological evidence and surgical treatment. J Neurosurg. 2009; 110: 1250-1255. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18976058
  15. Zeng T, Shi SS, Lin YF. Chronic subdural hematoma associated with sylvian arachnoid cyst in juvenile athletes: report of two cases and literature review. Chin J Traumatol. 2011; 14: 174-177. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21635806
  16. Isik HS, Yildiz O, Ceylan Y. Chronic subdural hematoma caused by soccer ball trauma associated with arachnoid cyst in childhood: case report. J Neurol Sci (Turk). 2011; 28: 398-401.
  17. Maher CO, Garton HJ, Al-Holou WN, Trobe JD, Muraszko KM, et al. Management of subdural hygromas associated with arachnoid cysts. J Neurosurg Pediatr. 2013; 12: 434-443. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24011368
  18. Edmondson L, Upshaw JE, Tuuri RE. A 14-year-old male with a 10-week history of headaches. Pediatr Ann. 2014;43: 222-223. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24972416
  19. Takizawa K, Sorimachi T, Honda Y, Ishizaka H, Baba T, et al. Chronic Subdural Hematomas Associated with Arachnoid Cysts: Significance in Young Patients with Chronic Subdural Hematomas. Neurol Med Chir (Tokyo). 2015; 55: 727-734. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605080/
  20. 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; 109:118-130. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28962953
  21. Sun J, Wang W, Wang D, An S, Xue L, et al. Clinical analysis of 10 patients of chronic subdural hematoma associated with arachnoid cyst. Zhonghua Yi Xue Za Zhi. 2017; 23; 97: 1502-1504. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28535643
  22. Cress M, Kestle JR, Holubkov R, Riva-Cambrin J. Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case-control study. Neurosurgery. 2013; 72: 716-722. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23313978
  23. Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA. 1999; 282: 36-39. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10404909
  24. Wester K, Helland CA. How often do chronic extra-cerebral haematomas occur in patients with intracranial arachnoid cysts? J Neurol Neurosurg Psychiatry. 2008; 79: 72-75. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17488784
  25. Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, et al. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. 2013; 118: 222-231. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23140149
  26. Robinson R. Congenital cyst of the brain: arachnoid malformations. Progr Neurosurg 1971; 4: 133-174.
  27. LaCour F, Trevor R, Carey M. Arachnoid cyst and associated subdural hematoma. Observations on conventional roentgenographic and computerized tomographic diagnosis. Arch Neurol. 1978; 35: 84-89. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/623534
  28. Page A, Paxton RM, Mohan D. A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma. J Neurol Neurosurg Psychiatry. 1987; 50:1001-1007. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/3655804
  29. Takayasu T, Harada K, Nishimura S, Onda J, Nishi T, et al. Chronic subdural hematoma associated with arachnoid cyst. Two case histories with pathological observations. Neurol Med Chir (Tokyo). 2012; 52: 113-117.PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22362297
  30. Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery. 1997; 40: 483-490. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9055286
  31. Kusuno K, Yoshida Y, Takahashi A, Ishii S. Chronic subdural hygroma caused by rupture of arachnoid cyst. As a probable course of chronic subdural hematoma-case report. Neurol Med Chir (Tokyo). 1984 ; 24: 349-354. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6206419
  32. Shim YS, Park CO, Hyun DK, Park HC, Yoon SH. What are the causative factors for a slow, progressive enlargement of a chronic subdural hematoma? Yonsei Med J. 2007; 30; 48: 210-217. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17461518
  33. Haines DE, Harkey HL, Al-Mefty O. The “subdural” space: a new look at an outdated concept. Neuurosurgery. 1993; 32:111-120. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8421539
  34. Zuckerman SL, Prather CT, Yengo-Kahn AM, Solomon GS, et al. Sport-related structural brain injury associated with arachnoid cysts: a systematic review and quantitative analysis. Neurosurg Focus. 2016; 40: E9. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27032926
  35. 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; 19:1017-1027. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12482115
  36. Müslüman AM, Özöner B, Kirçelli A, Can SM, Yilmaz A, et al. Chronic subdural hematoma associated with arachnoid cyst of the middle fossa : Surgical treatment and mid-term results in fifteen patients. Turk Neurosurg. 2018; 28: 776-782. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/29131236
  37. Aoki N, Sakai T. Intraoperative subdural hematoma in a patient with arachnoid cyst in the middle cranial fossa. Childs Nerv Syst. 1990; 6: 44-46. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2311116
  38. Servadei F, Vergoni G, Frattarelli M, Pasini A, Arista A, et al. Arachnoid cyst of middle cranial fossa and ipsilateral subdural haematoma: diagnostic and therapeutic implications in three cases. Br J Neurosurg. 1993; 7: 249-253. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8338645

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Figure 1

Figure 5

Similar Articles

Recently Viewed

  • Pattern of Eye Disease in Nenwe Rural Eye Clinic, Nigeria: A Seven Year Review
    Nnenna Maureen Ozioko*, Nkiru Mary Okoloagu, Emmanuel Sunday Onah and Catherine Nnenna Maureen Ozioko*, Nkiru Mary Okoloagu, Emmanuel Sunday Onah, Catherine. Pattern of Eye Disease in Nenwe Rural Eye Clinic, Nigeria: A Seven Year Review. Int J Clin Exp Ophthalmol. 2024: doi: 10.29328/journal.ijceo.1001056; 8: 004-015
  • Retinopathy of prematurity - Intersibling divergence of risk factors among twins
    Sudeep Navule Siddappa*, Kavitha Chikknayakanahalli Venugopal, Pavana Acharya and Tintu Susan Joy Sudeep Navule Siddappa*,Kavitha Chikknayakanahalli Venugopal,Pavana Acharya ,Tintu Susan Joy . Retinopathy of prematurity - Intersibling divergence of risk factors among twins. Int J Clin Exp Ophthalmol. 2020: doi: 10.29328/journal.ijceo.1001026; 4: 009-011
  • Effectiveness of levocetirizine in treating allergic rhinitis while retaining work efficiency
    Dabholkar Yogesh, Shah Tanush, Rathod Roheet, Paspulate Akhila, Veligandla Krishna Chaitanya, Rathod Rahul, Devesh Kumar Joshi* and Kotak Bhavesh Dabholkar Yogesh, Shah Tanush, Rathod Roheet, Paspulate Akhila, Veligandla Krishna Chaitanya, Rathod Rahul, Devesh Kumar Joshi*, Kotak Bhavesh. Effectiveness of levocetirizine in treating allergic rhinitis while retaining work efficiency. Arch Asthma Allergy Immunol. 2023: doi: 10.29328/journal.aaai.1001031; 7: 005-011
  • Hepatic Pseudolymphoma Mimicking Neoplasia in Primary Biliary Cholangitis: A Case Report
    Jeremy Hassoun, Aurélie Bornand, Alexis Ricoeur, Giulia Magini, Nicolas Goossens and Laurent Spahr* Jeremy Hassoun,Aurélie Bornand,Alexis Ricoeur,Giulia Magini,Nicolas Goossens,Laurent Spahr*. Hepatic Pseudolymphoma Mimicking Neoplasia in Primary Biliary Cholangitis: A Case Report. Arch Case Rep. 2024: doi: 10.29328/journal.acr.1001115; 8: 152-155
  • Other Applications of Amniotic Membranes: Case Series
    Linda Guerrero* Linda Guerrero*. Other Applications of Amniotic Membranes: Case Series. Arch Case Rep. 2024: doi: 10.29328/journal.acr.1001117; 8: 159-162

Read More

Most Viewed

Read More

Help ?