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Vol. 21. Issue 3.
Pages 222-227 (January 2010)
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Vol. 21. Issue 3.
Pages 222-227 (January 2010)
Hematoma subdural crónico asociado a quiste aracnoideo. Presentación de 12 casos
Chronic subdural hematoma associated with arachnoid cyst. Report of 12 cases
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M. Gelabert-González
Corresponding author
miguel.gelabert@usc.es

Correspondencia: Servicio de Neurocirugía. Hospital Clínico Universitario. A Choupana. 15706 Santiago de Compostela.
, D. Castro-Bouzas, A. Arcos-Algaba, J.M. Santín-Amo, L. Díaz-Cabanas, R. Serramito-García, E. Arán-Echabe, A. Prieto-González, A. García-Allut
Servicio de Neurocirugía. Hospital Clínico Universitario de Santiago de Compostela. Departamento de Cirugía. Universidad de Santiago de Compostela
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Resumen
Objetivos

Analizar las características clínicas, neurológicas y resultado neurorradiológico de una serie de pacientes con quiste aracnoideo asociado a un hematoma subdural crónico.

Pacientes y método

Revisamos retrospectivamente 12 casos de pacientes con quiste aracnoideo que presentaron como complicación un hematoma subdural crónico.

Resultados

Entre enero de 1984 y abril de 2008, 12 pacientes (0.9%) de 1.253 casos con hematoma subdural crónico presentaban un quiste aracnoideo intracraneal. La localización de los quistes fue en 10 casos en la fosa temporal y los otros dos en la convexidad. Los síntomas de presentación fueron cefalea en 6 pacientes (50%), seguidos por convulsiones (3 casos). En once pacientes se realizó agujero de trépano y drenaje del HSC, la paciente de más edad fue tratada de forma conservadora. Únicamente se trataron 3 quistes aracnoideos mediante craneotomía y fenestración, con resolución completa del quiste.

Conclusiones

Los pacientes con quiste aracnoideo, sobre todo si esta localizado en la fosa temporal, tienen un mayor riesgo de sufrir un hematoma subdural crónico. La primera opción terapéutica es el drenaje del hematoma subdural y si persiste la sintomatología deberá tratarse el quiste aracnoideo.

Palabras clave:
Espacio subdural
Quiste aracnoideo
Hematoma subdural crónico
Resonancia magnética
Traumatismo craneal
Abreviaturas:
AC
HSC
LCR
QA
Summary
Introduction

We designed this study to investigate the clinical, neurological, and radiological outcome of patients with chronic subdural hematoma related to an intracranial arachnoid cysts.

Patients and methods

Medical records of 12 cases of patients with arachnoids cyst complicated with chronic subdural hematoma were retrospectively reviewed.

Results

Between January 1984 and April 2008, 12 patients (0.9%) of 1.253 cases of chronic subdural hematoma surgically treated in our hospital had associated arachnoid cyst. Arachnoid cysts were located in the middle fossa (10 cases) and convexity (2 cases). The most frequent symptom was headache (6 cases), followed by seizures (3 cases). Eleven patients underwent burr hole and drainage; the oldest patient was treated conservatively.

Conclusions

Patients with AC, especially when these are located in temporal fossa, appear to harbour a life-long risk of contracting subdural hematoma. Hematoma evacuation is adequate at first operation and if arachnoid cyst is symptomatic or preoperative symptoms persist, additional arachnoid cyst surgery should be considered.

Key words:
Arachnoid cyst
Chronic subdural hematoma
Head injury
Magnetic resonance imaging
Subdural space

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