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Published on: June 18, 2021
Giant arachnoid granulation: differential diagnosis of acute headache
S A Peters1, E Frombach, C M Heyer
1Department of Radiology, BG-Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. soeren.peters@ruhr-uni-bochum.de
Abstract:
We present a case of intense, rapidly evolving headache clinically mimicking meningitis, subarachnoid haemorrhage or venous sinus thrombosis. Clinical examination, standard blood work and central nervous system studies were non-contributory and effectively ruled out these diagnoses. Cranial multidetector CT studies before and after application of intravenous contrast medium performed prior to lumbar tap disclosed a non-enhancing ovoid mass filling the superior sagittal sinus. This lesion posed a differential to venous sinus thrombosis, but ultimately fulfilled the criteria of a giant arachnoid granulation. The imaging characteristics and differential diagnosis of giant arachnoid granulations are discussed.
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