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Heading injury precipitating subdural hematoma associated with arachnoid cysts--two case reports
A Kawanishi1, M Nakayama, K Kadota
1Department of Neurosurgery, Kagoshima University School of Medicine.
Insights
Mild head trauma from soccer heading can cause subdural hematomas in children with middle cranial fossa arachnoid cysts. These cysts increase the risk of serious brain injury from minor impacts.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Radiology
Background:
- Arachnoid cysts in the middle cranial fossa are congenital brain malformations.
- These cysts can be asymptomatic or present with various neurological symptoms.
- Subdural hematomas are collections of blood between the dura mater and the arachnoid mater.
Observation:
- Two pediatric patients presented with subdural hematomas.
- Both patients had pre-existing arachnoid cysts in the middle cranial fossa.
- Symptoms of raised intracranial pressure were observed in both cases.
Findings:
- A history of heading a soccer ball was reported in both patients approximately 7 weeks prior to symptom onset.
- No other significant head trauma was identified.
- The subdural hematomas were considered complications of the arachnoid cysts, potentially triggered by mild head trauma.
Implications:
- Mild head trauma, such as soccer heading, may be a significant risk factor for developing subdural hematomas in individuals with arachnoid cysts.
- This highlights the importance of considering underlying pathologies like arachnoid cysts when evaluating head injuries in pediatric patients.
- Further research is warranted to understand the biomechanics of heading injuries in the context of arachnoid cysts.
Abstract:
A 14-year-old boy and a 11-year-old boy presented with subdural hematomas as complications of preexisting arachnoid cysts in the middle cranial fossa, manifesting as symptoms of raised intracranial pressure. Both had a history of heading the ball in a soccer game about 7 weeks and 2 days before the symptom occurred. There was no other head trauma, so these cases could be described as "heading injury." Arachnoid cysts in the middle cranial fossa are often associated with subdural hematomas. We emphasize that mild trauma such as heading of the ball in a soccer game may cause subdural hematomas in patients with arachnoid cysts.