• Promod Pillai, Sajesh K Menon, Raju P Manjooran, Rajiv Kariyattil, Ashok B Pillai, and Dilip Panikar.
• Department of Neurological Surgery, the Ohio State University Medical Center, Hamilton Hall, Neil Avenue, Columbus, Ohio 43210, USA. promod.pillai@osumc.edu.
• J Med Case Rep. 2009 Jan 1; 3: 53.

IntroductionIntracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature.Case PresentationWe report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma.ConclusionIt is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

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