Giant arachnoid granulation: Differential diagnosis of acute headache

Authors: Peters, SA; Frombach, E¹; Heyer, CM²

Source: Australasian Radiology, Volume 51, Supplement 1, October 2007 , pp. B18-B20(1)

Publisher: Blackwell Publishing

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Abstract:

SUMMARY

We present a case of intense, rapidly evolving headache clinically mimicking meningitis, subarachnoid haemorrhage or venous sinus thrombosis. Clinical examination, standard blood work and central nervous system studies were non-contributory and effectively ruled out these diagnoses. Cranial multidetector CT studies before and after application of intravenous contrast medium performed prior to lumbar tap disclosed a non-enhancing ovoid mass filling the superior sagittal sinus. This lesion posed a differential to venous sinus thrombosis, but ultimately fulfilled the criteria of a giant arachnoid granulation. The imaging characteristics and differential diagnosis of giant arachnoid granulations are discussed.

Keywords: giant arachnoid granulation; headache; multidetector computer tomography

Document Type: Research article

DOI: 10.1111/j.1440-1673.2007.01823.x

Affiliations: 1: Neurology, BG-Kliniken Bergmannsheil, Ruhr-University Bochum, Bochum, Germany 2: Departments of Radiology and

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