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Non-haemorrhagic subdural collection complicating rupture of a middle cranial fossa arachnoid cyst

Departments of Neuroradiology, Hope Hospital, Salford Royal Hospitals NHS Trust, Stott Lane, Salford, Manchester M6 8HD and Royal Manchester Children's Hospital, Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, UK

View larger version (86K): [in a new window]   Figure 1. (a) Unenhanced CT brain demonstrating a right subdural effusion causing mass effect and (b) a left middle cranial fossa arachnoid cyst. The right Sylvian fissure demonstrates notable prominence of low (cerebrospinal fluid) density consistent with an underlying right-sided middle cranial fossa arachnoid cyst.

View larger version (84K): [in a new window]   Figure 2. Unenhanced CT brain following shunt drainage of the right subdural collection. Only a small residual effusion remains (with some air). The left middle cranial fossa cyst appears unchanged. The presence of the right middle cranial fossa cyst is more readily appreciated.

View larger version (141K): [in a new window]   Figure 3. Axial T2 weighted MR brain performed 6 months later, confirming the re-accumulation of the right middle cranial fossa arachnoid cyst as indicated by the interval increase in size as well as the presence of the unaltered left middle cranial fossa arachnoid cyst. No subdural collection was present this time.