Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child.

Muhammad Faisal Khilji,Rana Shoaib Hamid,Faisal Al Azri,Niranjan Lal Jeswani

doi:10.1155/2016/6964713

Muhammad Faisal Khilji, Rana Shoaib Hamid + Show 2 more

Open Access

https://doi.org/10.1155/2016/6964713

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Abstract

Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma.

Highlights

Arachnoid cysts are common childhood developmental anomalies, but their association with spontaneous subdural hygroma is rare [1,2,3]
Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes
Minor head injury is known to result in subdural hygroma or hematoma due to rupture of arachnoid cyst; spontaneous rupture of arachnoid cyst may occur rarely [3]

Summary

Introduction

Arachnoid cysts are common childhood developmental anomalies, but their association with spontaneous subdural hygroma is rare [1,2,3]. Minor head injury is known to result in subdural hygroma or hematoma due to rupture of arachnoid cyst; spontaneous rupture of arachnoid cyst may occur rarely [3]. Most of these cysts are in middle cranial fossa where they are likely to be symptomatic if they are large. Chances of expansion are greatest in middle cranial fossa [1] They are more common in males as compared to females [3, 4]. In children they are frequently associated with seizures and cranial deformity [1, 5, 6]

Case Report

Discussion

Findings

Conflict of Interests