Brain herniation into arachnoid granulation

Case contributed by Magdi Mahsoub
Diagnosis certain

Presentation

The patient presented with headache. No history of trauma.

Patient Data

Age: 40 years
Gender: Female

Small herniation of the left temporal lobe into the left transverse sinus (axial T1 C+ fat sat, sagittal T1 C+ fat sat, coronal T1 C+ fat sat).

MRV shows small filling defect at the left transverse sinus.

Few supratentorial unspecific small white matter areas of high T2/FLAIR signal.

Mild obliteration of paransal sinuses by mucosal thickening suggesting sinusitis.

Case Discussion

The radiological features are typical for brain herniation into dural sinus.

Brain herniation into arachnoid granulation (BHAG) is the brain tissue present in or in vicinity of a presumed preexisting arachnoid granulation (AG). Arachnoid granulation represents protrusion of arachnoidea into the dura matter or venous sinus 1.

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