Chronic subdural hematoma complicating arachnoid cyst secondary to soccer-related head injury: case report

OBJECTIVE AND IMPORTANCE: Soccer has become a popular sport, with more than 200 million Federation International Football Association-registered soccer players worldwide and 16 million participants in the United States. The risk of sustaining a significant head injury from a strike to a soccer ball with the head is unknown, but it may be increased with the presence of an underlying congenital arachnoid cyst. CLINICAL PRESENTATION: We describe the case of a 16-year-old female patient who sustained a large chronic and subacute subdural hematoma without a loss of consciousness from being struck on the head by a soccer ball. Because of the large size of the hematoma and her contralateral symptoms, surgery was performed. INTERVENTION: A temporal craniotomy for evacuation of a large chronic and subacute subdural hematoma with removal and fenestration of the arachnoid cyst resulted in resolution of her symptoms. Rigid craniotomy fixation of this small operative flap should allow the patient to return to soccer participation in the future. CONCLUSION: Although many may not consider soccer a contact sport, recent epidemiological data suggest that it is a common cause of sports-related concussion. In addition, as our case report demonstrates, there is a risk of significant intracranial injury and hematoma formation subsequent to a strike on the head by a soccer ball, and arachnoid cysts may contribute an additional risk of head injury.