"Giant" arachnoid granulations just like CSF? NOT!!

Christopher R. Trimble, H. R. Harnsberger, M. Castillo, M. Brant-Zawadzki, A. G. Osborn

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


"Giant" AGs (>1 cm) are uncommon and can be misdiagnosed as venous sinus pathology such as a neoplasm or thrombosis. Seventeen patients with a total of 19 venous sinus AGs of >1 cm were collected from contributing authors. MR imaging was available for all AGs; CT, for 5/19; and DSA, for 7/19. Intra-AG fluid was compared with CSF in subarachnoid spaces. Nonfluid AG tissue was compared with gray matter. Diagnosis was based on imaging findings. Fluid within giant AGs did not follow CSF signal intensity on at least 1 MR image in nearly 80% (15/19) of AGs. Nine of these 15 AGs had CSF-incongruent signal intensity on ≥2 MR images. CSF-incongruent signal intensity was seen in 8/8 AGs on FLAIR, 7/10 on precontrast T1WI, 13/19 on T2WI, and 8/14 on contrast-enhanced T1WI. Nonfluid signal intensity was present in 18/19 AGs and varied from absent/hypointense (intra-AG flow voids) to gray matter isointense (stromal tissue).

Original languageEnglish (US)
Pages (from-to)1724-1728
Number of pages5
JournalAmerican Journal of Neuroradiology
Issue number9
StatePublished - Oct 2010
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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