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Case No. 727
2025-08-01~2025-08-31
출제자 : 황인평
Hit : 393
| Period | 2025-08-01~2025-08-31 |
|---|---|
| Diagnosis | arachnoid cyst with intracystic (and subdural) hemorrhage |
| Gender |
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| Age | 52 |
| Clinical information | A 52-year-old man presented with a headache that had worsened for the past week. What was the diagnosis? (No evidence of trauma Hx) |
| Discussion | Arachnoid cyst - Accounts for ~1% of non-traumatic brain lesions - Congenital origin due to meningeal maldevelopment - Most common in middle cranial fossa (50–65%), slight left-side and male predominance, usually asymptomatic Hemorrhagic Complication - Rare: <30 reported cases of intracystic hemorrhage with subdural hematoma - Proposed Mechanisms: 1. Rupture of bridging or leptomeningeal vessels due to arachnoid tear 2. Gradual cyst enlargement → increased internal pressure → rupture and bleeding Diagnosis - Hemorrhage may obscure the cyst on imaging! Reference Kim SJ et al. Investig Magn Reson Imaging. 2016 Jun;20(2):120-122 |
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