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Brain herniation into giant arachnoid granulation of the sigmoid sinus

Case contributed by Yves Leonard Voss
Diagnosis certain

Presentation

Non-specific headache.

Patient Data

Age: 20 years
Gender: Female

A large arachnoid granulation projects into the left sigmoid sinus into which herniates part of the interior temporal lobe. No edema. No evidence of intracranial hypertension.

Case Discussion

Unusually large brain herniation into a giant arachnoid granulation of the left sigmoid sinus.

In the scientific literature, there appears to be an ongoing debate on the clinical significance of these lesions in patients with headaches, epilepsy or intracranial hypertension.

Caution is advised in patients with planned transvenous neurointerventional procedures, and these lesions should not be mistaken for dural venous sinus thrombosis.

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