The controversial entity of brain herniations into arachnoid granulations: A report of three cases with literature review

Urszula Maria Ciochon; Per Cai Sehested; Hanne Pernille Bro Skejø; Jacob Miehe; Ina Nørgaard; Nitesh Shekhrajka

doi:10.1016/j.radcr.2021.06.080

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The controversial entity of brain herniations into arachnoid granulations: A report of three cases with literature review

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The controversial entity of brain herniations into arachnoid granulations: A report of three cases with literature review

Urszula Maria Ciochon, Per Cai Sehested, Hanne Pernille Bro Skejø, Jacob Miehe, Ina Nørgaard and Nitesh Shekhrajka

Radiology case reports, Vol.16(9), pp.2768-2773

09/01/2021

DOI: 10.1016/j.radcr.2021.06.080

PMCID: PMC8326588

PMID: 34367392

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Abstract

Brain herniation into arachnoid granulation (BHAG) is a quite recently described controversial entity in terms of both etiology and clinical significance. It comprises a herniation of brain tissue into a presumed preexisting arachnoid granulation in dural venous sinuses, calvarium, meningeal or diploic veins. Most often described as an incidental finding in patients examined for unrelated pathologies, some BHAGs can possibly be related to headache, epilepsy or conditions with increased intracranial pressure such as idiopathic intracranial hypertension (IIH) or pseudotumor cerebri (PTC). The number of reported cases is low and there are only three more recently published observational studies on this subject with results lacking statistical significance due to relatively few BHAGs analyzed. Therefore, BHAGs still need an increased focus from both the radiologists and clinicians and more published studies and cases are necessary to help in understanding their factual meaning, clinical and treatment implications. In this article we describe three new cases of BHAGs to the literature, with patients presenting with different symptoms.

Arachnoid granulation

Brain herniation

Magnetic resonance imaging

Details

Title: Subtitle: The controversial entity of brain herniations into arachnoid granulations: A report of three cases with literature review
Creators: Urszula Maria Ciochon - Copenhagen University Hospital
Per Cai Sehested - Aleris Hamlet Hospital
Hanne Pernille Bro Skejø - Aleris Hamlet Hospital
Jacob Miehe - Regional Hospital Holstebro
Ina Nørgaard - Copenhagen University Hospital
Nitesh Shekhrajka - Copenhagen University Hospital
Resource Type: Journal article
Publication Details: Radiology case reports, Vol.16(9), pp.2768-2773
Publisher: Elsevier Inc
DOI: 10.1016/j.radcr.2021.06.080
PMID: 34367392
PMCID: PMC8326588
ISSN: 1930-0433
eISSN: 1930-0433
Language: English
Date published: 09/01/2021
Academic Unit: Radiology
Record Identifier: 9984697730702771

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