蛛网膜囊肿通常无症状,偶然发现。然而,由于轻微的头部创伤,囊肿偶尔会破裂。我们描述了5例蛛网膜囊肿破裂患者的放射学随访,其特征是自发消退,硬膜下潮瘤形成,囊性和硬膜下出血。从2004年1月到2020年7月,在我们机构当时遇到的388例蛛网膜囊肿患者中,有5例(1.3%)蛛网膜囊肿破裂的患者进行了评估。5名患者均为男性,他们的年龄从6-17岁不等(中位数,12年)。放射学随访的中位持续时间为3.5年(范围,2.3-10.1年)。所有破裂的蛛网膜囊肿均覆盖颞叶,具有II型Galassi。囊肿的中位直径为4.9cm(范围,4.4-8.9厘米)。四名患者最近有轻微的头部外伤史。在所有患者的过去病史中都没有特殊的神经系统症状。在后续行动中,两名患者囊肿自行消退,无出血。一名患者的囊肿解决了慢性硬膜下出血的钻孔后引流。另一个病人,囊肿导致出血和慢性硬膜下出血,开颅手术后康复,血肿清除,和囊肿开窗术.另一个病人,呈现水瘤,囊性出血,慢性硬膜下出血,采用毛刺孔排水处理。3例患者术后康复。蛛网膜囊肿很少破裂,一些与出血相关的病例需要手术干预。术后,在本系列中,所有患者均有良好的结局,且无并发症.
Arachnoid cysts are usually asymptomatic and discovered incidentally. However, cysts may occasionally rupture because of minor head trauma. We describe the radiologic follow-up of 5 patients with ruptured arachnoid cysts featuring spontaneous resolution, subdural hygroma formation, and cystic and subdural hemorrhage. From January 2004 through July 2020, 5 patients (1.3%) with ruptured arachnoid cysts were evaluated out of 388 patients with arachnoid cysts encountered at our institution at that time. The 5 patients were all male, and they ranged in age from 6-17 years (median, 12 years). The median duration of radiologic follow-up was 3.5 years (range, 2.3-10.1 years). All of the ruptured arachnoid cysts were overlying the temporal lobe with Galassi type II. The median cyst diameter was 4.9 cm (range, 4.4-8.9 cm). Four patients had a history of recent minor head trauma. There were no particular neurologic symptoms in their past medical history in all patients. In the follow-up, two patients\' cysts resolved spontaneously without hemorrhage. One patient\'s cyst resolved post-burr-hole drainage for chronic subdural hemorrhage. Another patient, whose cyst led to a hemorrhage and chronic subdural hemorrhage, recovered following a craniotomy, hematoma removal, and cyst fenestration. Another patient, presenting with hygroma, cystic hemorrhage, and chronic subdural hemorrhage, was treated with burr-hole drainage. Three patients recovered postoperatively. Arachnoid cysts rarely rupture, and surgical intervention is required for some cases associated with hemorrhage. Postoperatively, all patients had good outcomes without complications in this series.