Ruptured aneurysm associated with arachnoid cyst: intracystic hematoma without subarachnoid hemorrhage

Surg Neurol. 1995 Apr;43(4):353-6. doi: 10.1016/0090-3019(95)80062-l.


Background: It is well-known that arachnoid cysts of the middle fossa are associated often with chronic subdural hematomas and/or intracystic hemorrhages. However, reports of an arachnoid cyst associated with an aneurysm are rare.

Case description: A 45-year-old man was admitted with headache due to intracystic hemorrhage in the sylvian fissure, associated with a saccular aneurysm at the bifurcation of the internal carotid artery. The aneurysm ruptured into the arachnoid cyst, without causing a subarachnoid hemorrhage. Subsequently, the neck of the aneurysm was clipped successfully. The patient's postoperative course was uneventful, and there was no vasospasm.

Conclusions: This is the first reported case of an intracystic hematoma due to a ruptured aneurysm. We discuss the possible etiology of the association between the aneurysm and the arachnoid cyst, and the formation mechanism for the intracystic hematoma that did not result in a subarachnoid hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Arachnoid Cysts / complications*
  • Hematoma / etiology*
  • Humans
  • Intracranial Aneurysm / etiology*
  • Male
  • Middle Aged
  • Rupture, Spontaneous
  • Subarachnoid Hemorrhage / etiology