Arachnoid cyst of the middle fossa complicated by spontaneous subdural hematoma and intracranial hypertension: Case report

Introduction: Chronic subdural hematomas (CSDH) are common problems in neurosurgery, generally secondary to head trauma, although they me be in rare cases associated to underlying pathologies. Between these possible causes, arachnoid cysts (usually asymptomatic benign congenital lesions) can be a risk factor for subdural hematoma in young patients, who may spontaneously develop a CSDH and require surgery to relieve intracranial hypertension.Case Report.We present the case of a 23-year-old male, incidentally diagnosed two years before with a right temporal arachnoid cyst (middle fossa), asymptomatic, who began with symptoms of intracranial hypertension two weeks prior to surgery. A right fronto-parieto-temporal CSDH was verified on MRI, requiring emergency surgery with a small craniotomy, evacuation of the hematoma, and fenestration of the arachnoid cyst. Conclusions: In young patients with a diagnosis of an arachnoid cyst, the differential diagnosis of CSDH should be considered when presenting with acute neurological symptoms.