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Item Spontaneous Spinal Subarachnoid Hemorrhage with Residual Arachnoid Cyst: A Case Report(2017) Derle, Eda; Iyigundogdu, Ilkin; Yilmaz, Cem; 0000-0003-2122-1016; 0000-0001-7860-040X; 0000-0002-2353-8044; 27593750; AAI-8830-2021; AAJ-2053-2021; AAK-2948-2021Spinal subarachnoid hemorrhage is a rare condition that usually occurs because of secondary causes and idiopathic spontaneous ones are extremely rare. We report a 56-year-old woman who presented with severe headache, neck pain and urinary retention. Magnetic resonance imaging revealed subarachnoid hemorrhage that extended from T1 to lumbar vertebrae. She was treated conservatively and symptoms were resolved within 1 month. An asymptomatic arachnoid cyst was observed on the follow-up magnetic resonance imaging after 3 months with no neurologic deterioration. She was still stable clinically and radiologically at the end of 19 months. Spinal subarachnoid hemorrhage is a surgical emergency, although in some cases a conservative approach may be useful.Item Chronic Subdural Hematoma Associated with Arachnoid Cyst of the Middle Fossa: Surgical Treatment and Mid-Term Results in Fifteen Patients(2018) Kircelli, Atilla; Musluman, Ahmet Murat; Ozsoner, Baris; Can, Songul Meltem; Yilmaz, Adem; Kaldirimoglu, Ayca; Sahin, Balkan; 0000-0003-2109-1274; 29131236AIM: To report neurological and radiological features, surgical management, and mid-term outcomes of patients with chronic subdural hematoma (CSDH) associated with ipsilateral arachnoid cyst (AC) of the middle fossa. MATERIAL and METHODS: A total of 453 patients with CSDH were treated at our clinic between August 2004 and August 2012. Of these patients, 15 had ipsilateral AC in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma. The AC was left intact in 14 patients, and one patient had no surgical intervention. The follow-up period ranged from 13 to 88 months (mean 43.07 +/- 23.23 months). RESULTS: The patients with AC associated CSDH were found to be younger than the patients with CSDH alone, and the mean age of 58 patients was 13.15 +/- 13.17 years, while it was 11 +/- 14.22 years in the other patients. Eleven patients had experienced head trauma at 21-50 days before admission. Hematoma evacuation through a single burr hole with closed-system subdural drainage performed at 2-4 days after surgery improved the symptoms in all patients. Two patients developed subdural fluid collection, which was treated by subduroperitoneal shunt placement. CONCLUSION: Greater prevalence of ACs in patients with CSDHs has been reported in the literature. We recommend the drainage of the hematoma via a single craniostomy and to leave the AC intact as the first choice of treatment if the associated AC is a Galassi type I or II. Additional subduroperitoneal shunting may be performed in patients with Galassi type III cyst.