Chronic Subdural Hematoma Associated with an Arachnoid Cyst in Elderly, an Intraoperative Finding after Re-Bleeding: Case Report

Intracranial arachnoid cysts (AC) are believed to be congenital and chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury. The association between these two entities sporadically occur in relatively young patients but rare in elderly patients. We report a 65-year-old man who presented with headache and dizziness of 2 months’ duration with a history of head injury. Brain computed tomography (CT) a CSDH in right side and a hygroma in left side. After first operation with burr holes in both sides, the patient underwent an early recurrence of acute subdural hematoma in the right side. The evacuation of this hematoma by a craniotomy allowed seeing an AC that we resected partially with complete recovery of the patient. The association CSDH/AC is rare and possible in elderly patients and there is no consensus on treatment.

Y-shaped shunt for the treatment of Dandy-Walker malformation combined with giant arachnoid cysts:A case report

BACKGROUND Dandy-Walker malformation(DWM)was first reported in 1914.In this case report,a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typical DWM.CASE SUMMARY The patient was at 20 mo old boy,with the complaint of staggering for more than 2 mo.He was admitted to the hospital due to high intracranial pressure and staggering.At admission,the patient had typical manifestations of high intracranial pressure,including vomiting,poor appetite and feeding difficulty.Physical examination revealed increased head circumference,closed anterior fontanelle,unstable standing,staggering,leaning right while walking and ataxia.After admission,he was diagnosed with DWM accompanied by giant isolated arachnoid cysts in the posterior fossa.He underwent Y-shaped three-way valve repair for treating differential pressure between the supratentorial hydrocephalus and the subtentorial arachnoid cysts at once.The child recovered well after the surgery.CONCLUSION In this case,supratentorial and subtentorial shunts were placed,which solved the problem of differential pressure between the supratentorial and subtentorial parts simultaneously.This provides useful information regarding treatment exploration in this rare disease.

Comparative Study on Two Surgical Procedures for Middle Cranial Fossa Arachnoid Cysts

In this study, we explored the operation options for middle cranial fossa arachnoid cysts （MCFAC）. One hundred and forty-nine patients who were operated for a symptomatic MCFAC between 1993 and 2006 in our hosptial were analyzed. Follow-up time ranged from 1 y to 14 y （mean=5.4 y）. All these patients were divided into three subgroups according to Galassi classification. Long-term outcome and complications were studied respectively. Fenestration （F） resulted in a more favorable long-term outcome and less complication for cysts of types I and Ⅱ, whereas a favorable outcome was noted in type Ⅲ patients who underwent cysto-peritoneal shunting （S）. We are led to conclude that Fenestration is suitable for cysts of types Ⅰ and Ⅱ （Galassi classification）, cysto-peritoneal shunting is better for cysts of type Ⅲ.

Transforaminal endoscopic excision of bi-segmental noncommunicating spinal extradural arachnoid cysts:A case report and literature review

BACKGROUND Spinal extradural arachnoid cysts(SEACs)are a rare cause of spinal cord compression.Typically,these cysts communicate with the intradural subarachnoid space through a small defect in the dural sac.For symptomatic SEACs,the standard treatment is to remove the cyst in total with a(hemi)laminectomy or laminoplasty.We present a rare case of bi-segmental non-communicating SEACs and describe our experience of using an endoscopic minimal access technique to remove bi-segmental non-communicating SEACs.CASE SUMMARY A 79-year-old female presented with pain related to bi-segmental SEACs at the T11-L1 segments.She underwent sequential transforaminal percutaneous endoscopic thoracic cystectomy of the SEACs.Following her first procedure,spinal magnetic resonance imaging demonstrated complete excision of the cyst at the T12-L1 segment.However,the cyst at the T11-T12 segment was still present.Thus,a second procedure was performed to remove this lesion.The patient’s right-sided lumbar and abdominal pain improved significantly postoperatively.Her Japanese Orthopaedic Association score increased from 11 to 25,her visual analogue scale score was reduced from 8 to 1.The physical and mental component summary of the 36-item short-form health survey(SF-36)were 15.5 and 34.375 preoperatively,and had increased to 79.75 and 77.275 at the last follow-up visit,respectively.CONCLUSION Bi-segmental non-communicating SEACs are extremely rare.Endoscopic surgery is a safe,effective,and reliable method for treating these cysts.In the event of bisegmental SEACs,it is important to identify whether both cysts are communicating before surgery,and if not,to remove both cysts separately during the index surgery to avoid re-operation.

Hematoma within the Outer Membrane of the Arachnoid Cyst Located in the Middle Fossa: A Mechanism of Development of Chronic Subdural Hematoma Associated with Arachnoid Cysts

It is well known that chronic subdural hematoma (CSDH) occasionally arises in patients harboring an arachnoid cyst (AC) located in the middle fossa. Although the pathogenesis of CSDH associated with ACs remains unknown, several possible mechanisms have been proposed. In many reported cases, the patients with ACs in the middle fossa would be symptomatic according to development of CSDH. A 9-year-old girl presenting with a headache, nausea, and diplopia was referred to our department. Magnetic resonance imaging showed an AC in the left-side middle fossa and ipsilateral CSDH with a remarkable mass effect. Irrigation of the CSDH, partial removal of the outer membrane of the AC and CSDH, and endoscopic cystocisternostomy were performed to relieve her symptoms. Postoperative clinical course was excellent. Histopathological examination of the outer membrane of the CSDH demonstrated an arachnoid cell layer and hemorrhage from the granulation inside the membrane, and collagen fibers outside the membrane. These findings strongly suggested that the membrane and the content of the CSDH were derived from the outer membrane of the AC, and the CSF including the hemorrhage within the membrane, respectively. Laceration and hemorrhage from granulation tissue within the outer membrane of the AC are considered as one of the developmental mechanisms of the CSDH associated with AC in the middle fossa.

Treatment strategy of intracranial arachnoid cysts

Objective To investigate treatment strategy of intracranial arachnoid cysts. Methods 47 cases of Intracranial arachnoid cysts from Sep 1,2010 to Des 1,2010 were analyzed. 25 cases received no intervention but follow . 22 cases received operation,13 of 22 cases neuroendoscopic partial cystectomy and communication between cystic cavity and brain cistern; 7 of 22 cases cysts peritoneal shunt, 2 of 22

The neurosurgical treatment of intracranial arachnoid cysts in child

Objective Arachnoid cysts are non-arachnoid fluid collections that accout for about 1% of all intracranial space-occupying lessions. So far,the optimal method of treatment for symptomatic arachnoid cysts remains controversial. In this article,we want to find an ideal technique

Imaging in pulmonary hydatid cysts

Hydatid disease is a zoonosis that can involve almost any organ in the human body. After the liver, the lungs are the most common site for hydatid disease in adults. Imaging plays a pivotal role in the diagnosis of the disease, as clinical features are often nonspecific. Classical radiological signs of pulmonary hydatid cysts have been described in the literature, aiding in the diagnosis of the disease. However, complicated hydatid cysts can prove to be a diagnostic challenge at times due to their atypical imaging features. Radiography is the initial imaging modality. Computed tomography can provide a specific diagnosis in complicated cases. Ultrasound is particularly useful in peripheral lung lesions. The role of magnetic resonance imaging largely remains unexplored.

Intraparenchymal hemorrhage after surgical decompression of an epencephalon arachnoid cyst: A case report

BACKGROUND This study reports the clinical presentation of intraparenchymal hemorrhage as a rare complication after surgical decompression of an intracranial epencephalon arachnoid cyst(IEAC)at the posterior cranial fossa.CASE SUMMARY The clinical information of a patient with an IEAC was reported,and the related literature was reviewed.A female patient with nausea presented to our hospital.Computed tomography demonstrated an IEAC located at the posterior cranial fossa,which was large and required surgical intervention.After operation,postoperative intraparenchymal hemorrhage was detected.She had a good recovery with conservative treatment 1 mo later.CONCLUSION Though postoperative intraparenchymal hemorrhage is rare after surgical decompression of an IEAC,more attention should be paid to such a complication.

Symptomatic Extra-Dural Arachnoid Cyst

Objective: The aim of this study is to report a case of arachnoid cyst due to mass effect on the thoracic marrow. Observation: A 15-year-old patient was admitted to our institution and complaining of high back pain. Three months before he developed progressive and occasional back pain with thoracic irradiation in hemi-belt, increased by the dorsal decubitus. Neurological examination revealed a spasmodic paraplegia. The muscular strength was quoted as 2 to the left and 3 to the right on a scale of 5. Magnetic resonance imaging (MRI) revealed and extradural cyst located to the dorsal spinal cord. The ablation of a voluminous translucent cyst was achieved after a vast decompressive laminectomy from the sixth to the eighth thoracic vertebra. The dural communication with the cyst was stitched. After surgery, the pain has disappeared and the neurological recovery was progressive over a period of 21 days. The diagnosis of arachnoid cyst was confirmed by histological examination. Conclusion: The extradural thoracic arachnoid cyst is a rare affection of good forecast. In the symptomatic form, the surgery as soon as possible remains the solution. The MRI keeps all its interest for the diagnostic orientation and the therapeutic strategy.

Giant Intracranial Arachnoid Cyst Causing Acute Neurologic Symptoms

Intracranial arachnoid cysts (IAC) are benign lesions containing cerebrospinal fluid (CSF). Most of them are clinically silent and remain static in size. However some may present with mild and slow progressive symptoms caused by the cyst. The authors present the case of 54-year-old woman who presented with acute symptoms of severe headache, vomiting, and gait disturbance of 2 day’s duration. She had no history of head trauma. On admission, neurological examination revealed that the patient had a Glasgow Coma Scale score of 15, and a left side hemiplegia. A CT scan revealed a hypodense fluid collection in the right frontoparietal region that mimicked an arachnoid cyst. The symptoms were improved after an emergency marsupialisation via craniotomy.

Analysis of cases of self-displaced and healed shunt of arachnoid cyst and review of literature

Objective:To investigate the causes,pathogenesis and prognosis of shunt displacement in arachnoid cyst.Methods:Retrospective analysis was made on the case of the left frontal top arachnoid cyst peritoneal shunt self-extraneous and cured in our hospital in November 2019.Combined with literature review,the treatment and prognosis of shunt displacement after arachnoid cyst peritoneal shunt were discussed.Results:Arachnoid cyst disappeared children heal,clinical symptoms improved,wipe out the shift shunt,literature review arachnoid cyst peritoneal shunt tube shift and recover rare,mainly for the shunt tube distal displacement,falling in the scrotum,emergence anus,and shift to the chest,or even a heart,required reoperation processing,timely deal with good prognosis.Conclusion:Arachnoid cyst peritoneal shunt may be an effective method for the treatment of cerebral convex arachnoid cyst in children,and it also suggests that the shunt tube can be removed after the disappearance of cerebral convex arachnoid cyst.Shunt tube displacement is rare in clinic and needs timely surgical treatment.

Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report

Adult posterior fossa arachnoid cysts are rare lesions that are considered to be mostly congenital in origin. We present 49-year-old man admitted with a chief complaint of tremor and balance problems for the past 2 months. He had ataxia on examination. Magnetic resonance imaging revealed a well circumscribed midline cystic lesion of the posterior fossa sharing the same signal characteristics as cerebrospinal fluid and non-communicating to the fourth ventricle. He underwent surgical treatment for his symptomatic posterior fossa arachnoid cyst with a good outcome at 2 years follow up.

Two months old with arachnoid cyst and unusual clinical presentation

Arachnoid cysts are relatively uncommon in infancy and are incidental findings in intracranial imaging in pediatric patients. Presentation at a younger age is usually associated with cyst enlargement. Arachnoid cysts are considered to be congenital in origin but the natural history and prevalence is not well defined. Here we report a case of a 2 months old male infant with non-specific illness who was diagnosed with arachnoid cyst.

Left Temporal Lobe Arachnoid Cyst Presenting with Symptoms of Psychosis

Arachnoid cysts are uncommon benign neurological tumors,and having presentation like schizophrenia,which has been reported in association with this cyst.The presence of psychiatric disturbances of arachnoid cyst has not been clearly mentioned in the literature.Even though,the appearance of some of the references that focuses on a possible link between arachnoid cysts and psychotic symptoms.Here we present a case report of a 35-year-old man,characterized by the insidious onset of psychotic symptoms of varying intensity such as multiple physical assaults on people with stone.Due to organic suspicion one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation.

The therapeutic strategies for the slit ventricle syndrome after cyst-peritoneal shunting for the temporal arachnoid cyst in children:six cases report and literatures review

Objective To investigate early diagnosis evidences,optimal therapeutic strategies and the prophylactic methods of the slit ventricle syndrome (SVS) in the temporal lobe arachnoid cysts patients who received the cyst-peritoneal(CP) shunting. Methods Six cases of SVS in the temporal lobe arachnoid cysts patients

胎儿蛛网膜囊肿磁共振随访研究

目的 探讨胎儿蛛网膜囊肿随胎龄及年龄增长而发生的形态改变及预后评估。方法 选取磁共振诊断蛛网膜囊肿18例胎儿的MRI资料及其相应产后随诊资料,通过随访对比蛛网膜囊肿部位、大小变化及周围组织关系等方面数据进行总结。结果 位于幕下蛛网膜囊肿10例,其中右侧小脑延髓池1例,四叠体池右侧1例,右侧小脑半球后方2例,小脑蚓下方偏左1例,后颅窝中线处5例。位于幕上8例,其中中间帆腔区域1例,小脑幕右上方1例,左右侧颞极各3例。18例胎儿中15例随访至生后;另3例胎儿期随访2次,产后未遵嘱随访。蛛网膜囊肿逐渐增大11例,其中后颅窝中线处仅1例增大。生后进行性脑积水4例,3例发生于偏中线处,1例位于中间帆腔区域。结论 胎儿蛛网膜囊肿因部位不同,其结局具有一定差异。部分蛛网膜囊肿有随胎龄及年龄增大趋势,偏中线处蛛网膜囊肿更容易进行性增大,胎儿期其增长速度及对邻近脑组织的受压、脑室梗阻变化相对产后变化要慢。

基于深度学习的曲面体层片颌骨病变辅助诊断技术研究

目的 探讨深度学习应用于曲面体层片辅助诊断颌骨透射病变、颌骨阻射病变的效果,以减少漏诊,辅助医生早期筛查、提高诊断准确性。方法 本研究通过四川大学华西口腔医院伦理委员会批准。以443例曲面体层片为研究对象,构建YOLO v8m-p2神经网络模型,将标注后的图像分为训练集354例,验证集45例和测试集44例,用于模型训练、验证和测试。采用精确率、召回率、F-1分值、G分值、mAP50评价模型的检测性能。结果 443例曲面体层片涵盖颌骨常见的良性病变,其中颌骨透射病变数量为318,包括含牙囊肿、牙源性角化囊肿、成釉细胞瘤3类病变;颌骨阻射病变数量为145,包含特发性骨硬化、牙瘤、牙骨质瘤、牙骨质-骨结构不良4类病变,样本有良好的代表性。YOLO v8m-p2神经网络模型识别颌骨病变的性能:精确率为0.887,召回率为0.860,F-1分值为0.873,G分值为0.873,mAP50为0.863。其中,含牙囊肿、牙源性角化囊肿、成釉细胞瘤召回率分别为0.833、0.941、0.875。结论 YOLO v8m-p2神经网络模型应用于初步检测口腔曲面体层片中的颌骨透射病变及颌骨阻射病变以及多分类检测颌骨透射病变时诊断性能表现良好,可辅助医生筛查曲面体层片的颌骨疾病。

犬含牙囊肿病例报告

本院接诊了1例乳齿未脱、右下颌恒犬齿缺失的患犬病例,将患犬麻醉后采用口腔探查和X线检查的方法进行诊断,初步诊断该患犬为含牙囊肿,即由未萌出的右下颌恒犬齿发育过程中相关的残留上皮所形成。手术拔除未萌发犬齿,使用刮匙将囊壁完整去除,用金刚砂车针打磨囊壁齿槽骨并使用生理盐水冲洗囊腔,结节缝合齿龈黏膜,术后恢复良好。患犬于术后3个月复查,镇静后拍摄口腔X线片,可见有新骨生成,无囊肿复发表现。表明治疗含牙囊肿时,拔除未萌发的牙齿并将囊壁清理干净,可获得良好的预后,但需要结合口腔X线和组织病理学检查结果进行诊断,后续需要进行影像学监测。

原发性后腹膜囊肿1例报道

1病例报告患者,女,59岁。因“右侧腰腹部疼痛3小时”入院。患者3小时前睡觉时无明显诱因出现右侧腰腹部剧烈疼痛,醒来后仍感腰背部持续性刺痛,无腹泻,无心慌、胸闷、气短。后行上腹部CT平扫(图1、图2)及增强(图3、图4、图5)示:肝右后方腹膜下囊性占位性病变,大小约5.0cm×6.6cm,边界清,CT值约70HU,相邻肝脏受压推移,囊壁少许点状钙化,动态增强检查:动脉期、门脉期及延迟期均无明显强化。