Arachnoid cyst with subdural hematoma

Case contributed by Kosuke Kato
Diagnosis almost certain

Presentation

Three month history of generalized headache. Nil precipitating trauma.

Patient Data

Age: 30 years
Gender: Male

Large left temporal cyst with expansion and scalloping of the left middle cranial fossa. There is no abnormal enhancement or restricted diffusion. 

There is a left convexity subdural collection measuring up to 14mm in depth with mixed density layering on both T1- and T2-weighted sequences. Increased T1 signal and corresponding low T2 signal and associated blooming artefact on susceptibility imaging consistent with hemorrhagic content of the collection. Mild mass effect on the left lateral ventricle but there is no transpendymal edema. 

Conclusion: Large left temporal arachnoid cyst with a separate left convexity subdural hematoma of varying chronicity.

Case Discussion

The patient underwent a burr hole drainage of the left sided subdural hematoma.

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