Abstract
A 49-year-old male was hospitalized with a 1-month history of persistent headache and vomiting. Computed tomography (CT) revealed left middle fossa arachnoid cysts and a chronic subdural hygroma. The cysts were excised after evacuation of the subdural hygroma. Postoperatively, the patient did not regain consciousness and CT showed multiple intracerebral hemorrhages in both the supra and infratentorial spaces. Three months postoperatively, he was discharged with mental deficits and right hemiparesis. A review of the literature indicates that the possible pathogenic mechanism in this case was a sudden increase in cerebral blood flow due to faulty autoregulation. This devastating complication may have been avoided by simple drainage of the subdural hygroma, perhaps with the addition of cyst-peritoneal shunting.
