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J Neurol Surg A Cent Eur Neurosurg 2021; 82(06): 604-610
DOI: 10.1055/s-0040-1721021
Case Report

Head Injury without Head Blow? A Rare Case of Subdural Hematoma Associated with Minute Arachnoid Cyst in a Teenage Skater

Jacek Szczygielski
1   Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
2   Instutute of Neuropathology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
3   Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
,
Dorothea München
1   Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
,
Ralf Ketter
1   Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
,
Lukas Ràkàsz
4   Department of Neurosurgery, Queens Elisabeth Hospital Birmingham, Birmingham, United Kingdom
,
Walter Schulz-Schaeffer
2   Instutute of Neuropathology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
,
Joachim Oertel
1   Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany
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Abstract

Background Skateboarding has been reported to cause diverse kinds of injuries, including head trauma. However, the risk of brain injury without direct blow to the head seems to be underestimated. In particular, the impact of the inertial forces related to the vigorous character of skateboarding tricks is not sufficiently recognized.

Case Description In our report, we demonstrate a case of chronic subdural hematoma developing without previous blow to the head in a 17-year-old skater bearing small frontal convexity arachnoid cyst.

Conclusion Based on the described case, the possibility of acceleration and angular forces related to skate park leisure activities resulting in subdural hematoma needs to be discussed. This risk should be critically appraised in patients carrying arachnoid cyst as a malformation predisposing to develop subdural bleeding.

Keywords

arachnoid cyst - chronic subdural hematoma - skateboard

Authors' Contributions

J.S., L.R., and J.O. came up with the concept and design of the study. J.S., D.M., and R.K. contributed to the acquisition of data. J.S. and L.R. contributed to the analysis and interpretation of data. J.S., L.R., W.S.-S., and J.O. drafted the article. J.S., L.R., and J.O. critically revised the article and reviewed the submitted version of the manuscript. J.S. approved the final version of the manuscript on behalf of all the authors. J.S., W.S.-S., and J.O. provided administrative/technical/material support. J.O. supervised the study.




Publication History

Received: 03 January 2020

Accepted: 19 March 2020

Article published online:
04 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Skate Review, 45 Skateboarding Stats You Need to Know. 2018 . Available at: http://www.skatereview.com/skateboard-stats/. Accessed November 26, 2019
    PubMed
  • 2 Haines C, Smith TM, Baxter MF. Participation in the risk‐taking occupation of skateboarding. J Occup Sci 2010; 17 (04) 239-245
    CrossrefPubMedGoogle Scholar
  • 3 Ma N, Mills S, McBride C, Kimble R, Redmond M. Neurological injuries from skateboards in paediatric and adolescent populations: injury types and severity. ANZ J Surg 2018; 88 (04) 337-340
    CrossrefPubMedGoogle Scholar
  • 4 Tominaga GT, Schaffer KB, Dandan IS, Coufal FJ, Kraus JF. Head injuries in hospital-admitted adolescents and adults with skateboard-related trauma. Brain Inj 2015; 29 (09) 1044-1050
    CrossrefPubMedGoogle Scholar
  • 5 Committee on Injury and Poison Prevention, American Academy of Pediatrics. Skateboard and scooter injuries. Pediatrics 2002; 109 (03) 542-543
    CrossrefPubMedGoogle Scholar
  • 6 Robinson RG. Congenital cysts of the brain: arachnoid malformations. Prog Neurol Surg 1971; 4: 133-174
    CrossrefPubMedGoogle Scholar
  • 7 Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg 2013; 118 (02) 222-231
    CrossrefPubMedGoogle Scholar
  • 8 Vernooij MW, Ikram MA, Tanghe HL. et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007; 357 (18) 1821-1828
    CrossrefPubMedGoogle Scholar
  • 9 Al-Holou WN, Yew AY, Boomsaad ZE, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in children. J Neurosurg Pediatr 2010; 5 (06) 578-585
    CrossrefPubMedGoogle Scholar
  • 10 Parsch CS, Krauss J, Hofmann E, Meixensberger J, Roosen K. Arachnoid cysts associated with subdural hematomas and hygromas: analysis of 16 cases, long-term follow-up, and review of the literature. Neurosurgery 1997; 40 (03) 483-490
    PubMedGoogle Scholar
  • 11 Domenicucci M, Russo N, Giugni E, Pierallini A. Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: neuroradiological evidence and surgical treatment. J Neurosurg 2009; 110 (06) 1250-1255
    CrossrefPubMedGoogle Scholar
  • 12 Servadei F, Vergoni G, Frattarelli M, Pasini A, Arista A, Fagioli L. Arachnoid cyst of middle cranial fossa and ipsilateral subdural haematoma: diagnostic and therapeutic implications in three cases. Br J Neurosurg 1993; 7 (03) 249-253
    CrossrefPubMedGoogle Scholar
  • 13 Kwak YS, Hwang SK, Park SH, Park JY. Chronic subdural hematoma associated with the middle fossa arachnoid cyst: pathogenesis and review of its management. Childs Nerv Syst 2013; 29 (01) 77-82
    CrossrefPubMedGoogle Scholar
  • 14 Di Rocco C. Sylvian fissure arachnoid cysts: we do operate on them but should it be done?. Childs Nerv Syst 2010; 26 (02) 173-175
    CrossrefPubMedGoogle Scholar
  • 15 Tamburrini G, Dal Fabbro M, Di Rocco C. Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst 2008; 24 (05) 593-604
    CrossrefPubMedGoogle Scholar
  • 16 Hou K, Li CG, Zhang Y, Zhu BX. The surgical treatment of three young chronic subdural hematoma patients with different causes. J Korean Neurosurg Soc 2014; 55 (04) 218-221
    CrossrefPubMedGoogle Scholar
  • 17 Zeng T, Shi SS, Lin YF. Chronic subdural hematoma associated with sylvian arachnoid cyst in juvenile athletes: report of two cases and literature review. Chin J Traumatol 2011; 14 (03) 174-177
    PubMedGoogle Scholar
  • 18 Bilginer B, Onal MB, Oguz KK, Akalan N. Arachnoid cyst associated with subdural hematoma: report of three cases and review of the literature. Childs Nerv Syst 2009; 25 (01) 119-124
    CrossrefPubMedGoogle Scholar
  • 19 Mori K, Yamamoto T, Horinaka N, Maeda M. Arachnoid cyst is a risk factor for chronic subdural hematoma in juveniles: twelve cases of chronic subdural hematoma associated with arachnoid cyst. J Neurotrauma 2002; 19 (09) 1017-1027
    CrossrefPubMedGoogle Scholar
  • 20 Albuquerque FC, Giannotta SL. Arachnoid cyst rupture producing subdural hygroma and intracranial hypertension: case reports. Neurosurgery 1997; 41 (04) 951-955 , discussion 955–956
    CrossrefPubMedGoogle Scholar
  • 21 Zuckerman SL, Prather CT, Yengo-Kahn AM, Solomon GS, Sills AK, Bonfield CM. Sport-related structural brain injury associated with arachnoid cysts: a systematic review and quantitative analysis. Neurosurg Focus 2016; 40 (04) E9
    CrossrefPubMedGoogle Scholar
  • 22 Wu X, Li G, Zhao J, Zhu X, Zhang Y, Hou K. Arachnoid cyst-associated chronic subdural hematoma: report of 14 cases and a systematic literature review. World Neurosurg 2018; 109: e118-e130
    CrossrefPubMedGoogle Scholar
  • 23 Demetriades AK, McEvoy AW, Kitchen ND. Subdural haematoma associated with an arachnoid cyst after repetitive minor heading injury in ball games. Br J Sports Med 2004; 38 (04) E8
    CrossrefPubMedGoogle Scholar
  • 24 Prabhu VC, Bailes JE. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report. Neurosurgery 2002; 50 (01) 195-197 , discussion 197–198
    PubMedGoogle Scholar
  • 25 Hamada H, Hayashi N, Umemura K, Kurosaki K, Endo S. Middle cranial fossa arachnoid cyst presenting with subdural effusion and endoscopic detection of tear of the cyst: case report. Neurol Med Chir (Tokyo) 2010; 50 (06) 512-514
    CrossrefPubMedGoogle Scholar
  • 26 Page A, Paxton RM, Mohan D. A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma. J Neurol Neurosurg Psychiatry 1987; 50 (08) 1001-1007
    CrossrefPubMedGoogle Scholar
  • 27 Varma TR, Sedzimir CB, Miles JB. Post-traumatic complications of arachnoid cysts and temporal lobe agenesis. J Neurol Neurosurg Psychiatry 1981; 44 (01) 29-34
    CrossrefPubMedGoogle Scholar
  • 28 Wester K, Helland CA. How often do chronic extra-cerebral haematomas occur in patients with intracranial arachnoid cysts?. J Neurol Neurosurg Psychiatry 2008; 79 (01) 72-75
    CrossrefPubMedGoogle Scholar
  • 29 Cress M, Kestle JR, Holubkov R, Riva-Cambrin J. Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case-control study. Neurosurgery 2013; 72 (05) 716-722 , discussion 722
    CrossrefPubMedGoogle Scholar
  • 30 Okura A, Noguchi S, Yuge T, Maruiwa H, Matsunaga M, Shigemori M. A case of convexity arachnoid cyst associated with chronic subdural hematoma and intracystic hemorrhage. No Shinkei Geka 1994; 22 (03) 273-277
    PubMedGoogle Scholar
  • 31 Keller TM, Holland MC. Chronic subdural haematoma, an unusual injury from playing basketball. Br J Sports Med 1998; 32 (04) 338-339
    CrossrefPubMedGoogle Scholar
  • 32 Tsuzuki N, Katoh H, Ohtani N. Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report. Neurosurgery 2003; 53 (01) 242-243 , author reply 243
    CrossrefPubMedGoogle Scholar
  • 33 Carmont MR, Mahattanakul W, Pigott T. Acquisition of a chronic subdural haematoma during training for competitive race walking?. Br J Sports Med 2002; 36 (04) 306-307
    CrossrefPubMedGoogle Scholar
  • 34 Wang DH, Kostyun RO, Solomito MJ. The biomechanics of cranial forces during figure skating spinning elements. Conn Med 2015; 79 (03) 133-137
    PubMedGoogle Scholar
  • 35 Ommaya AK, Yarnell P. Subdural haematoma after whiplash injury. Lancet 1969; 2 (7614): 237-239
    PubMedGoogle Scholar
  • 36 Knowles BM, MacGillivray SR, Newman JA, Dennison CR. Influence of rapidly successive head impacts on brain strain in the vicinity of bridging veins. J Biomech 2017; 59: 59-70
    CrossrefPubMedGoogle Scholar
  • 37 Frederick EC, Determan JJ, Whittlesey SN, Hamill J. Biomechanics of skateboarding: kinetics of the Ollie. J Appl Biomech 2006; 22 (01) 33-40
    CrossrefPubMedGoogle Scholar
  • 38 Determan JJ, Frederick EC, Cox JS, Nevitt MN. High impact forces in skateboarding landings affected by landing outcome. Footwear Sci 2010; 2 (03) 159-170
    CrossrefPubMedGoogle Scholar
  • 39 Harding J, Mackintosh CG, Hahn AG, James DA. Classification of aerial acrobatics in elite half-pipe snowboarding using body mounted inertial sensors. In: Estivalet M, Brisson P. eds. The Engineering of Sport 7. Vol. 2. Paris: Springer; 2008: 447-456
    CrossrefGoogle Scholar
  • 40 Roldan-Valadez E, Facha MT, Martinez-Lopez M, Herrera-Mora P. Subdural hematoma in a teenager related to roller-coaster ride. Eur J Paediatr Neurol 2006; 10 (04) 194-196
    CrossrefPubMedGoogle Scholar
  • 41 Yamakami I, Mine S, Yamaura A, Fukutake T. Chronic subdural haematoma after riding a roller coaster. J Clin Neurosci 2005; 12 (01) 81-83
    CrossrefPubMedGoogle Scholar
  • 42 McNeil SL, Spruill WA, Langley RL, Shuping JR, Leonard III JR. Multiple subdural hematomas associated with breakdancing. Ann Emerg Med 1987; 16 (01) 114-116
    CrossrefPubMedGoogle Scholar
  • 43 De Cauwer H, Van Giel R, Mortelmans L, van den Hauwe L. An uncommon cause of headache after headbanging at a party. Eur J Emerg Med 2009; 16 (04) 212-213
    CrossrefPubMedGoogle Scholar
  • 44 Pirayesh Islamian A, Polemikos M, Krauss JK. Chronic subdural haematoma secondary to headbanging. Lancet 2014; 384 (9937): 102
    CrossrefPubMedGoogle Scholar
  • 45 Nitta N, Jito J, Nozaki K. Recurrent subdural hematoma secondary to headbanging: A case report. Surg Neurol Int 2015; 6 (Suppl. 18) S448-S450
    CrossrefPubMedGoogle Scholar