Presentation
Patient presents with 2 episodes of seizures with left arm stiffening.
Patient Data
MRI of the brain demonstrates an ovoid extra-axial lesion with circumscribed margin overlying the right parasagittal frontoparietal convexity. There is smooth bony remodeling of the overlying calvarium. The lesion is isointense on T1WI with a peripheral rim of hyperintensity. On T2/FLAIR, the lesion is hyperintense centrally with a peripheral rim of hypointensity. On SWI, there is peripheral hypointensity as well as curvilinear hypointensity in the underlying sulci, suggestive of subarachnoid hemorrhage. The sulci also display hyperintensity on FLAIR and T1WI with corresponding enhancement. The lesion restricts diffusion which is confirmed on ADC.
Case Discussion
This is a rare presentation of an arachnoid cyst with intracystic hemorrhage. The small amount of adjacent subarachnoid hemorrhage is related to cyst rupture. This was confirmed intraoperatively following resection.
Co-Author: Samantha Scott
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