Delayed Chronic Subdural Hematoma Associated with Temporal Arachnoid Cyst in Children: A Rare Case Report and Literature Review

Introduction: Chronic subdural hematoma (cSDH) is uncommon in children and even rarer when associated with congenital arachnoid cysts. This coexistence poses diagnostic and therapeutic challenges because the initial trauma and imaging findings are often insignificant or normal Case Presentation: An 11-year-old previously healthy boy presented with progressive headache and vomiting three months after a minor head injury. Initial brain CT immediately after the trauma was completely normal. On admission, a new CT scan revealed a left chronic subdural hematoma (17 mm thick, 12 mm midline shift) compressing the ipsilateral ventricle, together with a well-defined left temporal arachnoid cyst (38 × 22 × 44 mm). Burr-hole evacuation of the hematoma was performed under general anesthesia, without manipulation of the cyst. The postoperative course was uneventful, and the follow-up CT scan confirmed complete resolution Conclusions: Even minor head trauma in children with temporal arachnoid cysts can lead to delayed chronic subdural hematoma. Burr-hole evacuation alone provides excellent outcomes, and cyst fenestration is not always required. Recognizing this rare association is crucial for early diagnosis and optimal management.