Presentation and management of ruptured arachnoid Cyst

Sherin, Ahmed; Zidan, Ihab Helmy; Youssef, Hossam Ibrahim; Nasef, Nabil Amin

doi:10.21608/pajn.2024.297981.1133

Presentation and management of ruptured arachnoid Cyst

Document Type : Original Articles

Authors

¹ Lecturer of Neurosurgery Neurosurgery Department Alexandria Universtity

² Department of Neurosurgery. Alexandria University.

³ Arkansas Neuroscience Institute, USA.

⁴ Department of Neurosurgery. Kafr El-Sheikh University.

10.21608/pajn.2024.297981.1133

Abstract

Background Arachnoid cysts are incidentally detected in brain imaging. Most of these lesions are asymptomatic. They may rupture resulting in formation of subdural hygroma or hematoma with serious neurological sequelae.
Aim This study demonstrates the experience of a single tertiary referral center in dealing with the rare presentation of rupture arachnoid cyst assessing the clinical and radiological presentations and management whether conservative or surgical and revising the clinical and radiological outcomes.
Materials and Methods Retrospective study of 13 patients with ruptured arachnoid cyst presented between January 2014 and December 2022 with a minimum follow up period of 12 months. 11 patients of the studied group had surgery. 8 patients had bur hole evacuation, 2 had cystoperitoneal shunt, and one patient had subduroperitonial shunt. Data collected included patients’ demographic data, preoperative and postoperative clinical, and radiological data. Results were tabulated and analyzed.
Results The mean age at presentation was 7.9 years. There were 9 males. 10 patients had a history of head trauma in the last 30 days. Headache was the most common presentation. All patients had middle fossa arachnoid cysts of them 10 patients had left lesions. 8 (61.5%) patients had subdural hygromas, 4 (30.8%) patients had subdural hematomas.1(7.7%) patient had intra-cystic hematoma. All patients had favorable clinical and radiological postoperative outcomes.
Conclusion Rupture arachnoid cyst may represent a neurosurgical emergency when associated with intractable symptoms, focal neurological deficit or mass effect. This mandates urgent intervention either by bur hole evacuation or shunting achieving favorable clinical and radiological outcomes.

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