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Three patients with chronic subdural hematoma associated with middle fossa arachnoid cyst were treated by irrigating the hematoma through burr holes, because the symptoms were considered mainly due to increased intracranial pressure caused by the subdural hematoma. The symptoms disappeared immediately afterwards, so no surgery for the middle fossa arachnoid cyst was done. The patients were followed by magnetic resonance imaging. No subdural hematoma recurred during a postoperative period of 11 months to 2.5 years, and the arachnoid cyst reduced in size in two patients. We recommend irrigation of the subdural hematoma as the initial procedure of choice for such cases.
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