Abstract
A 25-year-old woman presented to the obstetric clinic in her first pregnancy. The patient was accompanied by her mother who reported an episode of intracerebral hemorrhage after birth and also remembered access to the emergency department after generalized tonic-clonic seizure as an infant. She was not able to describe the therapy for seizure preventions and even when and why it was suspended, but she affirmed that no residual neurological consequences were detected in the following years. Actually, the pregnant woman was in good health without neurological symptoms nor assumed any therapy. A neurologist reviewed the patient's CT scan in which arachnoid cyst and porencephalic cyst were evident, and he assessed that no abnormalities were found in motor, sensory, and mental state examination. EEG did not show any epileptiform or seizure-like activity. No antiepileptic drug was prescribed due to the absence of symptoms since many years. The patient had no neurological symptoms during pregnancy or obstetric complications and delivered at term a healthy baby through a caesarean section. She breastfed, and after two years, the patient and the baby are healthy. The association of porencephalic and arachnoid cyst in pregnancy is an extremely rare neurological condition that needs a multidisciplinary counseling in pregnancy, but an uneventful course is possible.
Highlights
Porencephalic cyst, both congenital and acquired, is an accumulation of cephalorachidian fluid (CSF) in a cavity of the brain parenchyma probably from peri- or postnatal ischemic or hemorrhage vascular events or from traumatic brain injuries
Clinical presentation is various as it is associated to differences in the sizes and sites of the lesions [3]: frontal lobe location may be associated with psychosis [4], whereas cerebral hemisphere involvement is associated with simple partial or generalized seizures [2]
We describe a pregnancy in a woman with porencephalic and arachnoid cyst, an extremely rare association of neurological pathologies
Summary
Porencephalic cyst, both congenital and acquired, is an accumulation of cephalorachidian fluid (CSF) in a cavity of the brain parenchyma probably from peri- or postnatal ischemic or hemorrhage vascular events or from traumatic brain injuries It is reported in 3.5 per 100,000 live births [1]. Arachnoid cysts can occur anywhere within the central nervous system, but they are most frequently (50-60%) located in the middle cranial fossa, where they invaginate into and widen the Sylvian fissure. In this location, they can be classified into three types based on their size with the Galassi classification. We describe a pregnancy in a woman with porencephalic and arachnoid cyst, an extremely rare association of neurological pathologies
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