Nermin TANIK, Mehmet ADAM, Asuman ÇELİKBİLEK, Turgay ATALAY, Aylin OKUR, Halil İbrahim SERİN

İNSİDENTAL ARACHNOİD GRANÜLASYON: VERTİGONUN NADİR BİR SEBEBİ

Araknoid granülasyonlar, araknoid membranın dural sinüsler içine doğru büyümesidir. Bu oluşum- lar, dural sinüsleri dolduracak ve genişletecek kadar büyüyebilir veya kafatasının iç sahasına açıla- bilir. Biz burada, bir haftadır başdönmesi şikayeti ile başvuran 56 yaşında erkek bir hasta sunuyo- ruz. Nörolojik ve göz dibi muayeneleri normal idi. Beyin bilgisayarlı tomografi taraması pariyetal kemiğin iç sahasında bilateral birden fazla litik alanlar gösterirken; bu lezyonlar manyetik rezonans görüntülemede (MRG) kontrast tutmayan tarzda olup dural sinüs tıkanıklığı ile ilişkili değildi. Baş- dönmesi vestibulosuppressan ilaçlar ile geriledi. Hiçbir müdahale planlanmadı ve hasta MRG ça- lışmaları ile takip edildi.

Incidental Arachnoid Granulation: A Rare Cause Of Vertigo

Arachnoid granulations are growths of arachnoid membrane into the dural sinuses. They may grow to fill and dilate the dural sinuses or expand the inner table of the skull. We report a 56- year-old man who presented with a one week history of vertigo. Neurological and fundoscopic examinations were normal. Brain computed tomography scan showed multiple lytic areas on the inner table of the parietal bone bilaterally whereas the lesions were not related to the occlusion of the dural sinuses on magnetic resonance imaging (MRI) without contrast enhancement. The vertigo resolved with vestibulosuppressant drugs. No intervention was planned and the patient was followed up through MRI studies.

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1. Amlashi SF, Riffaud L, Morandi X. Intracranial hypertension and giant arachnoid granulations. J Neurol Neurosurg Psychiatry. 2004; 75(1):172-3.
2. Brunori A, Vagnozzi R, Giuffrè R. Antonio Pacchioni (1665- 1726): early studies of the dura mater. J Neurosurg. 1993; 78(3):515-8.
3. Choi HJ, Cho CW, Kim YS, Cha JH. Giant arachnoid granulation misdiagnosed as transverse sinus thrombosis. J Korean Neurosurg Soc. 2008;43(1): 48-50.
4. Haybaeck J, Silye R, Soffer D. Dural arachnoid granulations and giant arachnoid granulations. Surg Radiol Anat. 2008; 30(5): 417-21.
5. Kan P, Stevens EA, Couldwell WT. Incidental giant arachnoid granulation. AJNR Am J Neuroradiol. 2006; 27(7): 1491-2.
6. Kiroglu Y, Yağci B, Cirak B, Karabulut N. Giant arachnoid granulation in a patient with benign intracranial hypertension. Eur Radiol. 2008; 18(10): 2329-32.
7. Koshikawa T, Naganawa S, Fukatsu H, Ishiguchi T, Ishigaki T. Arachnoid granulations on high-resolution MR images and diffusion-weighted MR images: normal appearance and frequency. Radiat Med. 2000; 18(3): 187-91.
8. Lee MH, Kim HJ, Lee IH, Kim ST, Jeon P, Kim KH. Prevalence and appearance of the posterior wall defects of the temporal bone caused by presumed arachnoid granulations and their clinical significance: CT findings. AJNR Am J Neuroradiol. 2008; 29(9): 1704-7.
9. VandeVyver V, Lemmerling M, De Foer B, Casselman J, Verstraete K. Arachnoid granulations of the posterior temporal bone wall: imaging appearance and differential diagnosis. AJNR Am J Neuroradiol. 2007; 28(4): 610-2.
10. Zheng H, Zhou M, Zhao B, Zhou D, He L. Pseudotumor cerebri syndrome and giant arachnoid granulation: treatment with venous sinus stenting. J Vasc Interv Radiol. 2010; 21(6): 927-9.