{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:12:34Z","timestamp":1780578754715,"version":"3.54.1"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Chronic subdural hematomas (cSDHs) present characteristic imaging findings, making the diagnosis straightforward. In rare cases, arachnoid cysts (ACs) may be associated with their formation. There is still no consensus regarding their treatment; Case Presentation: A young adult male presented with occipital headache. Neurological examination was normal. Laboratory investigations were within physiological limits. A CT scan revealed the presence of a Galassi Grade III temporo-parietal AC accompanied by a parietal epidural hematoma (EDH) on the right side. His medical history was significant for treated hypertension. There was no use of anticoagulants, antiplatelets, or history of trauma. Vascular pathology was excluded by MRA\/MRV. He was discharged for home care and was readmitted 10 days later after a repeat CT scan. A brief cognitive assessment with the Mini-Mental State Examination (MMSE) revealed mild cognitive impairment. A burr-hole evacuation was performed, and a drainage catheter was left in place for 24 h. Intraoperative findings were consistent with a chronic subdural hematoma. The patient was discharged with complete resolution of symptoms. A follow-up CT scan performed one month postoperatively confirmed the favorable result. Cognitive functions were normal on follow-up; Conclusions: A SDH may mimic the characteristics of an EDH in the presence of an AC. The most common symptom is cephalalgia. Neurocognitive impairment may occur secondary to elevated intracranial pressure. A burr-hole hematoma evacuation may be sufficient. Further treatment should be considered only in the case of complications associated with ACs.<\/jats:p>","DOI":"10.3390\/reports9020174","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:52:30Z","timestamp":1780573950000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic and Therapeutic Pitfalls Encountered in a Young Adult Patient with a Symptomatic Chronic Subdural Hematoma Mimicking a Subacute Epidural Hematoma in the Presence of a Galassi Grade III Arachnoid Cyst: Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6580-5382","authenticated-orcid":false,"given":"Marios","family":"Theologou","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, General Hospital of Thessaloniki Georgios Papanikolaou, 57013 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-8095","authenticated-orcid":false,"given":"Nikolaos","family":"Syrmos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, General Hospital of Thessaloniki Georgios Papanikolaou, 57013 Thessaloniki, Greece"},{"name":"School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2176-8986","authenticated-orcid":false,"given":"Vaitsa","family":"Giannouli","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Department of Psychology, Democritus University of Thrace, 68300 Didymoteicho, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"ref_1","unstructured":"Khairat, A., and Waseem, M. (2025). Epidural Hematoma. StatPearls, StatPearls Publishing."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e118","DOI":"10.1016\/j.wneu.2017.09.115","article-title":"Arachnoid Cyst\u2013Associated Chronic Subdural Hematoma: Report of 14 Cases and a Systematic Literature Review","volume":"109","author":"Wu","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jocn.2021.02.006","article-title":"Pitfalls in the diagnosis of subdural hemorrhage\u2014Mimics and uncommon causes","volume":"89","author":"Bordia","year":"2021","journal-title":"J. Clin. Neurosci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6645752","DOI":"10.1155\/2023\/6645752","article-title":"Organized Chronic Subdural Hematoma Mimicking Acute Epidural Hematoma","volume":"2023","author":"Cao","year":"2023","journal-title":"Case Rep. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s41984-023-00210-3","article-title":"Chronic epidural hematoma: A systematic review and meta-analysis","volume":"38","author":"Agada","year":"2023","journal-title":"Egypt. J. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1097\/00006123-199710000-00036","article-title":"Arachnoid Cyst Rupture Producing Subdural Hygroma and Intracranial Hypertension: Case Reports","volume":"41","author":"Albuquerque","year":"1997","journal-title":"Neurosurgery"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.3171\/2012.10.JNS12548","article-title":"Prevalence and natural history of arachnoid cysts in adults: Clinical article","volume":"118","author":"Terman","year":"2013","journal-title":"J. Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/0090-3019(82)90315-9","article-title":"Ct scan and metrizamide CT cisternography in arachnoid cysts of the middle cranial fossa: Classification and pathophysiological aspects","volume":"17","author":"Galassi","year":"1982","journal-title":"Surg. Neurol."},{"key":"ref_9","unstructured":"White, M.L., and Das, J.M. (2025). Arachnoid Cysts. StatPearls, StatPearls Publishing."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.3171\/2008.4.17509","article-title":"Relationship between supratentorial arachnoid cyst and chronic subdural hematoma: Neuroradiological evidence and surgical treatment: Clinical article","volume":"110","author":"Domenicucci","year":"2009","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00381-012-1896-4","article-title":"Chronic subdural hematoma associated with the middle fossa arachnoid cyst: Pathogenesis and review of its management","volume":"29","author":"Kwak","year":"2013","journal-title":"Childs Nerv. Syst."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1089\/089771502760341938","article-title":"Arachnoid Cyst Is a Risk Factor for Chronic Subdural Hematoma in Juveniles: Twelve Cases of Chronic Subdural Hematoma Associated with Arachnoid Cyst","volume":"19","author":"Mori","year":"2002","journal-title":"J. Neurotrauma"},{"key":"ref_13","first-page":"483","article-title":"Arachnoid Cysts Associated with Subdural Hematomas and Hygromas: Analysis of 16 Cases, Long-term Follow-up, and Review of the Literature","volume":"40","author":"Parsch","year":"1997","journal-title":"Neurosurgery"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"727","DOI":"10.2176\/nmc.oa.2015-0016","article-title":"Chronic Subdural Hematomas Associated with Arachnoid Cysts: Significance in Young Patients with Chronic Subdural Hematomas","volume":"55","author":"Takizawa","year":"2015","journal-title":"Neurol. Med. Chir."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1136\/jnnp.2007.117358","article-title":"How often do chronic extra-cerebral haematomas occur in patients with intracranial arachnoid cysts?","volume":"79","author":"Wester","year":"2008","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Moini, J., and Piran, P. (2020). Blood supply of the CNS. Functional and Clinical Neuroanatomy, Elsevier.","DOI":"10.1016\/B978-0-12-817424-1.00005-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100300","DOI":"10.1016\/j.bas.2021.100300","article-title":"Chronic Subdural Hematoma (cSDH): A review of the current state of the art","volume":"1","author":"Nouri","year":"2021","journal-title":"Brain Spine"},{"key":"ref_18","unstructured":"Jandial, R. (2020). Arachnoid Cyst Fenestration. Core Techniques in Operative Neurosurgery, Elsevier."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s00701-024-05950-1","article-title":"Evaluation of surgical treatment strategies and outcome for cerebral arachnoid cysts in children and adults","volume":"166","author":"Gencer","year":"2024","journal-title":"Acta Neurochir."},{"key":"ref_20","first-page":"312","article-title":"Decompression of Subdural Hematomas Using an Intraosseous Needle in the Emergency Department: A Case Series","volume":"4","author":"Barro","year":"2020","journal-title":"Clin. Pract. Cases Emerg. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1016\/S0140-6736(24)00686-X","article-title":"Burr-hole drainage with or without irrigation for chronic subdural haematoma (FINISH): A Finnish, nationwide, parallel-group, multicentre, randomised, controlled, non-inferiority trial","volume":"403","author":"Raj","year":"2024","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1056\/NEJMoa2313472","article-title":"Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma","volume":"391","author":"Davies","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Orscelik, A., Senol, Y.C., Bilgin, C., Kobeissi, H., Arul, S., Cloft, H., Lanzino, G., Kallmes, D.F., and Brinjikji, W. (2023). Middle meningeal artery embolization without surgical evacuation for chronic subdural hematoma: A single-center experience of 209 cases. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1222131"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1159\/000523709","article-title":"Cerebrospinal Fluid Homeostasis and Hydrodynamics: A Review of Facts and Theories","volume":"85","author":"Theologou","year":"2022","journal-title":"Eur. Neurol."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/174\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:52:02Z","timestamp":1780577522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/2\/174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["reports9020174"],"URL":"https:\/\/doi.org\/10.3390\/reports9020174","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]}}}