Clinical study of patients of arachnoid cyst associated with chronic subdural hematoma

Objective: To explore the clinical characteristics and treatment strategy of arachnoid cyst associated with chronic subdural hematoma.

Methods: A retrospective analysis was made for 11 cases of arachnoid cyst associated with chronic subdural hematoma at our hospital from December 1999 to December 2009. There were 9 males and 2 females with a mean age of 23.1 years old (range: 7 - 68). Their clinical characteristics were summarized. The symptoms included headache (n = 10) and facial muscle twitching & eye squinting (n = 1). History of previous head injury were found in 6 cases, strenuous exercise in 1 case and no history of injury in 4 cases.

Results: The clinical symptoms of 3 patients worsened after a conservative treatment and underwent a burred-hole procedure with drainage of hematoma. And 7/9 patients undergoing a burred-hole procedure with drainage of hematoma had a full recovery. But 2/9 had recurrent subdural hematoma at Days 20 and 40 post-operation respectively and underwent the same procedure. Another 2 cases underwent craniotomy to remove subdural hematoma and arachnoid cyst and had stayed free of any symptom since then. All patients were followed up for 10 - 154 months after discharge. And none had recurrent subdural hematoma. All could study, work or live normally with a KPS (Karnofsky performance scale) score of 80 or more.

Conclusions: Arachnoid cysts is a possible risk factor for subdural hematoma, especially in young adults. Chronic subdural hematoma generally develops within 1 - 3 months after head injury. And a common clinical presentation is headache. A burred-hole procedure with drainage of hematoma is adequate as the first-line treatment for arachnoid cyst associated with chronic subdural hematoma.