Analizar las características clínicas, neurológicas y resultado neurorradiológico de una serie de pacientes con quiste aracnoideo asociado a un hematoma subdural crónico.
Pacientes y métodoRevisamos retrospectivamente 12 casos de pacientes con quiste aracnoideo que presentaron como complicación un hematoma subdural crónico.
ResultadosEntre enero de 1984 y abril de 2008, 12 pacientes (0.9%) de 1.253 casos con hematoma subdural crónico presentaban un quiste aracnoideo intracraneal. La localización de los quistes fue en 10 casos en la fosa temporal y los otros dos en la convexidad. Los síntomas de presentación fueron cefalea en 6 pacientes (50%), seguidos por convulsiones (3 casos). En once pacientes se realizó agujero de trépano y drenaje del HSC, la paciente de más edad fue tratada de forma conservadora. Únicamente se trataron 3 quistes aracnoideos mediante craneotomía y fenestración, con resolución completa del quiste.
ConclusionesLos pacientes con quiste aracnoideo, sobre todo si esta localizado en la fosa temporal, tienen un mayor riesgo de sufrir un hematoma subdural crónico. La primera opción terapéutica es el drenaje del hematoma subdural y si persiste la sintomatología deberá tratarse el quiste aracnoideo.
We designed this study to investigate the clinical, neurological, and radiological outcome of patients with chronic subdural hematoma related to an intracranial arachnoid cysts.
Patients and methodsMedical records of 12 cases of patients with arachnoids cyst complicated with chronic subdural hematoma were retrospectively reviewed.
ResultsBetween January 1984 and April 2008, 12 patients (0.9%) of 1.253 cases of chronic subdural hematoma surgically treated in our hospital had associated arachnoid cyst. Arachnoid cysts were located in the middle fossa (10 cases) and convexity (2 cases). The most frequent symptom was headache (6 cases), followed by seizures (3 cases). Eleven patients underwent burr hole and drainage; the oldest patient was treated conservatively.
ConclusionsPatients with AC, especially when these are located in temporal fossa, appear to harbour a life-long risk of contracting subdural hematoma. Hematoma evacuation is adequate at first operation and if arachnoid cyst is symptomatic or preoperative symptoms persist, additional arachnoid cyst surgery should be considered.
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