Ortega SO, Gil AM, Tadeo MEG

Language: Spanish
References: 10
Page: 153-155
PDF size: 285.81 Kb.

ABSTRACT

Introduction: Arachnoid granulations are considered as "giants" when they exceed one cm in size and they are uncommon findings that may be mistaken by dural sinuses diseases.
Clinical case: A 44 years old male patient is reported with a primary headache of tension type without alarm or focal signs, two years after remission of a non-Hodgkin lymphoma. Cranial magnetic resonance images just revealed a 20 per 5 millimeters well defined structure within the right transverse sinus, which showed T1 and FLAIR-weighted images hypointensity and T2 hyperintensity, in correspondence with the characteristics of cerebrospinal fluid at the same weighted images.
Conclusions: A giant arachnoid granulation was diagnosed as a casual finding that was not related to the symptoms or to previous history of a malignant disease of the patient. It is possible to differentiate giant arachnoid granulations from dural sinuses diseases when an adequate correlation between clinical manifestations and magnetic resonance images is established.

REFERENCES

1. Chen F, Deng XF, Liu B, Zou LN, Wang DB, Han H. Arachnoid granulations of middle cranial fossa: a population study between cadaveric dissection and in vivo computed tomography examination. Surg Radiol Anat. 2011;33(3):215-21.

2. Holman DW, Kurtcuoglu V, Grzybowski DM. Cerebrospinal fluid dynamics in the human cranial subarachnoid space: an overlooked mediator of cerebral disease. In vitro arachnoid outflow model. J R Soc Interface. 2010;7(49):1205-18.

3. Yew M, Dubbs B, Tong O, Nager GT, Niparko JK, Tatlipinar A, Francis HW. Arachnoid granulations of the temporal bone: a histologic study of dural and osseous penetration. Otol Neurotol. 2011;32(4):602-9.

4. Trimble CR, Harnsberger HR, Castillo M, Brant-Zawadzki M and Osborn AG. "Giant" Arachnoid Granulations Just Like CSF?: NOT!! AJNR Am J Neuroradiol. 2010;31:1724-28.

5. Kan P, Stevens EA, Couldwell WT. Incidental giant arachnoid granulation. AJNR Am J Neuroradiol. 2006;27:1491–92.

6. Leach JL, Meyer K, Jones BV, Tomsick TA. Large arachnoid granulations involving the dorsal superior sagittal sinus: findings on MR imaging and MR venography. AJNR Am J Neuroradiol. 2008;29(7):1335-9. doi: 10.3174/ajnr.A1093.

7. Haybaeck J, Silye R, Soffer D. Dural arachnoid granulations and "giant" arachnoid granulations. Surg Radiol Anat. 2008;30(5):417-21.

8. Lu CX, Du Y, Xu XX, Li Y, Yang HF, Deng SQ, et al. Multiple occipital defects caused by arachnoid granulations: Emphasis on T2 mapping. World J Radiol. 2012;4(7):341-4. doi: 10.4329/wjr.v4.i7.341.

9. Strydom MA, Briers N, Bosman MC, Steyn S. The anatomical basis of venographic filling defects of the transverse sinus. Clin Anat. 2010;23(2):153-9.

10. Pérez Nellar J, Scherle Matamoros CE, Gil Alfonso M, Ortega Santiesteban O, Fernandez Cue L. Trombosis Venosa Cerebral en una paciente con Linfoma no Hodgkin en remisión. Reporte de caso clínico. Rev Ecuat Neurol. 2008;17(1-3):106-8.