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    Resolution of Middle Fossa Arachnoid Cyst after Minor Head Trauma - Stages of Resolution on MRI: Case Report and Literature Review. Nadi Mustafa,Nikolic Ana,Sabban Dalal,Ahmad Tahani Pediatric neurosurgery Arachnoid cysts (ACs) are frequently encountered in pediatric neurosurgical practice. Their natural history and optimum treatment are not well determined. The authors describe a resolution of asymptomatic middle fossa AC after trivial head trauma in a 7-year-old child. Intracystic bleeding was noticed on interval MRI. Serial MRI follow-up demonstrates stages of resolution of the AC that did not require surgical intervention. Few cases of nonsurgical AC disappearance have been reported, much fewer with trauma as a triggering factor. Here, we present the stages of resolution in images. 10.1159/000479325
    Disappearance of arachnoid cysts after head injury. Mori T,Fujimoto M,Sakae K,Sakakibara T,Shin H,Yamaki T,Ueda S Neurosurgery The mechanism of the disappearance of arachnoid cysts is not fully understood. This article discusses the spontaneous disappearance of these cysts after head injury. Five patients underwent computed tomography and were diagnosed as having a subdural hematoma or effusion associated with arachnoid cysts. In four of the five patients, the cyst decreased in size or disappeared. These cases suggest a possible mechanism by which this type of cyst associated with subdural hematoma or effusion might disappear. For the arachnoid cyst to disappear, the rupture of the cyst wall appears to be essential, and after rupture, subdural effusion must develop around the cyst. As this effusion is absorbed, the fluid in the cyst drains away, after which the cyst becomes smaller and gradually disappears. This hypothesis supports the possibility of a "natural cure" for arachnoid cysts without surgical intervention. 10.1227/00006123-199505000-00008
    Arachnoid cyst rupture with concurrent subdural hygroma. Donaldson J W,Edwards-Brown M,Luerssen T G Pediatric neurosurgery Arachnoid cysts (ACs) are relatively common intracranial mass lesions, which occur most often in the middle cranial fossa. While these lesions can present as a mass lesion, many are asymptomatic. Rarely, posttraumatic or spontaneous rupture of ACs can result in intracystic hemorrhage, subdural hematoma or subdural hygroma. We have encountered two cases of ruptured arachnoid cysts that resulted in subdural hygromas. Both patients harbored middle cranial fossa cysts and suffered mild closed head injuries. The presentation, radiographic findings and surgical management of these patients as well as the association between ACs and subdural hygromas are described. 10.1159/000028918
    Arachnoid cyst with spontaneous rupture into the subdural space. Cayli S R British journal of neurosurgery Spontaneous rupture of an arachnoid cyst into the subdural space is an unusual complication. Only six cases have been reported in the literature. We report here an additional case and review the literature concerning arachnoid cysts. The possible pathogenesis of this condition is discussed.
    Arachnoid cyst rupture with subdural hygroma: report of three cases and literature review. Gelabert-González Miguel,Fernández-Villa Juan,Cutrín-Prieto Juan,Garcìa Allut Alfredo,Martínez-Rumbo Ramón Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery INTRODUCTION:Arachnoid cysts are believed to account for about 1% of all intracranial expansive lesions, some remain inactive throughout life, others lie dormant for many years before clinical manifestation. In a few cases, arachnoid cysts have ruptured after cranial trauma or more rarely, spontaneously, with resultant subdural haemorrhage or CSF collection. CASE REPORT:We report three cases with traumatic rupture of arachnoid cyst into the subdural space in children, which is an extremely unusual complication. DISCUSSION:A review of the literature revealed only 18 previously reported cases. 10.1007/s00381-002-0651-7
    Spontaneous rupture of middle fossa arachnoid cysts: surgical series from a single center pediatric hospital and literature review. Balestrino Alberto,Piatelli Gianluca,Consales Alessandro,Cama Armando,Rossi Andrea,Pacetti Mattia,Fiaschi Pietro,Pavanello Marco Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery PURPOSE:Arachnoid cysts may present with symptoms deriving from cyst rupture, usually causing intracystic hemorrhage and subdural hematoma or hygroma. Rupture is usually caused by minor trauma, spontaneous rupture is an exceptional event, and 57 cases have been described in literature. We here present and discuss the largest series of spontaneously ruptured middle fossa arachnoid cysts in order to investigate clinical presentation and best treatment available. METHODS:We report a retrospective series of 17 pediatric patients surgically treated for middle fossa arachnoid cyst with signs of cyst rupture without a history of trauma in the previous 90 days. We describe clinical presentation, treatment, and outcome at follow-up discussing our results with a literature review including all reported cases of spontaneous rupture of middle fossa arachnoid cysts. RESULTS:In our experience patients most frequently presented with subdural hygroma, in literature, a chronic hematoma was most frequently reported. Headache is the most reported symptom at presentation. Neurological deficits and consciousness alterations are rare. Surgical treatment may resolve brain compression only or reduce rupture recurrence risk. Conservative treatment has also been proposed. Different treatments are reported and discussed focusing on indications, contraindications, risks, and expected benefits. CONCLUSION:We propose, when safely possible, microsurgical cyst fenestration in skull base cisterns as the treatment of choice for these patients as long as it addresses both immediate decompression and risk of rupture recurrence. We report good outcomes and low incidence of complications from our series with a mean postoperative follow-up of 30 months. 10.1007/s00381-020-04560-3
    What provokes a disappearing arachnoid cyst? - Case study and literature review. Haddad Gaelle,Alam Raquelle,Atweh Lamya Ann,Hourani Mukbil Clinical imaging OBJECTIVE:Intracranial Arachnoid cysts (AC) are stable cerebral spinal fluid (CSF)-filled sacs that can rarely undergo progressive shrinkage or disappearance throughout life. In this manuscript, we present a case of post-traumatic complete resolution of an AC, review the possible triggers of this phenomenon, and discuss the pathophysiological mechanisms behind them. METHODS:After presenting our case, we performed a literature review using the PubMed Database of all the reported cases of AC reduction or resolution (last updated in February 2021). Spontaneous cases were excluded. An analysis of the remaining cases (1985-2021) according to their inciting event, demographical, and clinical characteristics was then presented. RESULTS:58 patients were identified, 33 of which spontaneously resolved. The remaining 25 were included in the survey in addition to the case we presented. The mean age was 20.2 years, average time to resolution was 25.3 months, with only two third of the cases showing complete disappearance of the AC. A central nervous system infection was the inciting cause of resolution in one infant (4%), a history of head trauma in 16 (62%) patients and an intracranial procedure in 9 (35%) patients. DISCUSSION:AC disappearance is a rare phenomenon that can occur spontaneously or after an inciting event. The cyst wall rupture and CSF flow perturbation theories seem to be the most applicable pathophysiological mechanisms in triggered AC resolution. 10.1016/j.clinimag.2021.11.001