[Multiple intracerebral hemorrhages immediately after surgical excision of middle fossa arachnoid cysts and evacuation of chronic subdural hygroma. Case report].

A 49-year-old male was hospitalized with a 1-month history of persistent headache and vomiting. Computed tomography (CT) revealed left middle fossa arachnoid cysts and a chronic subdural hygroma. The cysts were excised after evacuation of the subdural hygroma. Postoperatively, the patient did not regain consciousness and CT showed multiple intracerebral hemorrhages in both the supra- and infratentorial spaces. Three months postoperatively, he was discharged with mental deficits and right hemiparesis. A review of the literature indicates that the possible pathogenic mechanism in this case was a sudden increase in cerebral blood flow due to faulty autoregulation. This devastating complication may have been avoided by simple drainage of the subdural hygroma, perhaps with the addition of cyst-peritoneal shunting.