Abstract
IntroductionArachnoid cysts (ACs) account for a small proportion of all intracranial lesions. They are often incidental but can become symptomatic and even cause a threat to life. Symptoms are usually due to direct compression of neural elements and/or raised intracranial pressure.Case reportWe report the case of an infant with an enlarging posterior fossa arachnoid cyst (PFAC) causing torticollis and gastro-oesophageal reflux (GOR), the combination of which had been previously unreported in this context. Endoscopic fenestration and cyst decompression were followed by complete resolution of the symptoms. We discuss the possible mechanisms of torticollis and GOR in this context.
Highlights
IntroductionArachnoid cysts (ACs) are congenital lesions [1,2,3,4] that account for approximately 1% of all intracranial lesions
Arachnoid cysts (ACs) account for a small proportion of all intracranial lesions
We report a rare presentation of posterior fossa arachnoid cyst (PFAC) with torticollis and gastro-oesophageal reflux (GOR) in a child, which resolved following endoscopic cyst fenestration
Summary
Arachnoid cysts (ACs) are congenital lesions [1,2,3,4] that account for approximately 1% of all intracranial lesions. We report a rare presentation of posterior fossa arachnoid cyst (PFAC) with torticollis and gastro-oesophageal reflux (GOR) in a child, which resolved following endoscopic cyst fenestration. The symptoms resolved post-operatively, with significant reduction in cyst size after fenestration (Fig. 4). A trans-fontanelle tap revealed a raised white cell count with no organisms detected He returned to surgery where the reservoir and intraventricular catheter were removed and replaced by an external ventricular drain (EVD). He received 14 days of intrathecal (IT) vancomycin and 16 days of intravenous meropenem and vancomycin. At 18-month follow-up he is fit and well, with no recurrence of symptoms
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