Traumatic Leptomeningeal Cyst Research Articles

Magnetic Resonance Imaging of Leptomeningeal Cyst with Atypical Presentation

Leptomeningeal cysts, also known as growing skull fractures, are rare complications of head trauma. It is usually seen a few months posttrauma. These lesions are rare in adults, with over 90% resulting from fractures occurring in children under the age of 3 years. The children usually present with enlarging scalp mass, seizures, focal neurological deficit, and headache. In this case series, we are going to present the two cases of post traumatic leptomeningeal cysts in adults, presenting as cough-induced headache along with imaging description.

Assessment of traumatic leptomeningeal cyst in forensic anthropology – A case report

Paleopathology is a very extensive subject. Sometimes some pathological changes of bones may mimic trauma. This paper demonstrates a rare complication of cranial fractures which may be mistaken with gunshot injury in skeletonized remains.

Post Traumatic Intradiploic Leptomeningeal Cyst in a 2 Year Old Child

Growth of post taumatic intradiploic leptomeningeal cyst following head trauma is one of the rare complications of skull fractures seen mainly in infancy and toddlers. It is characterized by progressive diastatic enlargement of the fracture line with progressively increasing pulsatile cystic mass filled with cerebrospinal fluid in diploic space. Herein, we report a case of 2 year old boy presented with huge soft, non-tender pulsatile growing mass on the frontal aspect 9 months after sustaining head injury. CT imaging delineated it as a post traumatic intradiploic leptomeningeal cyst in frontal bone secondary to superior sagittal suture diastasis. Cyst was meticulously excised from superior sagittal sinus followed by durocranioplasty.

Treatment of a Traumatic Leptomeningeal Cyst in an Adult with Fibrinogen-Based Collagen

Reports of traumatic leptomeningeal cysts (TLMC) are rare in adults. The standard treatment approach is craniectomy with careful exposure of the intact dural edges, followed by duroplasty. However, occasionally, the location of the TLMC makes achieving watertight duroplasty impossible. Herein, we report the case of a 28-year-old male who presented with a soft growing mass on the vertex of his head 16 months after the head trauma. Upon enhanced CT examination, a bony defect involving both the inner and outer table of the cranium was observed close to the sagittal sinus, and a well-defined cystic mass, 5 cm in diameter, was nested within the defect. The risks associated with extension craniotomy were high because the lesion was located superficial to the sagittal sinus, we opted to use fibrinogen-based collagen fleece (TachoCombR®) to repair the dural defect. Two months after surgery, the patient remained asymptomatic with a good cosmetic result. In cases like ours, when the defect is near the major sinuses and the risk of rupturing the sinus during watertight dural closure is high, fibrinogen-based collagen fleece (TachoComb®) is an effective alternative approach to standard dural suture techniques.

Adult Traumatic Leptomeningeal Cyst -Case Report-

A 60-year-old man presented with a traumatic leptomeningeal cyst manifesting as local tenderness in the right parietal region and local headache 2 years after head injury. Magnetic resonance imaging showed a small arachnoid cyst under bone defect. Dural and bone plasty were performed. Intraoperative examination found small and round defects of the dura and bone. Progressive headache was relieved after the surgery. This rare case of adult posttraumatic leptomeningeal cyst occurred within an unusually short period after trauma, and was associated with a small and round bone defect and small dural defect usually characteristic of congenital arachnoid cyst.

Traumatic Leptomeningeal Cyst in a 24-Year-Old Man: Case Report

Traumatic leptomeningeal cysts represent a rare complication of a childhood cranial fracture, and occur in only 0.05 to 0.6% of all cranial fractures. In adults, clinical manifestations of a childhood trauma are very rare and usually appear in the form of nontender, nonpulsatile, subcutaneous mass, accompanied by a progressive neurological deficit and seizures, as shown in our case. We present the case of a 24-year-old man with seizures caused by a traumatic leptomeningeal cyst resulting from the head injury he suffered at the age of 9 months. Right-sided craniotomy was performed with consequent microsurgical removal of the leptomeningeal cyst. The dura was reconstructed in a watertight manner and a cranioplasty was performed with Palacos (Howmedica International, Limerick, Ireland). It is important to consider traumatic leptomeningeal cysts when treating adult patients with erosive bone lesions who have a history of head trauma.

Déficit neurológico transitorio secundario a quiste leptomeníngeo en un paciente adulto

An uncommon complication of fractures of the skull in infancy is a leptomeningeal cyst, which is also known as a growing skull fracture. A post traumatic leptomeningeal cyst may occur in adults, but is much rarer and may be attributed to a fracture of the skull which occurred in childhood. This complication is caused by a tear in the dura mater, through which pulsation of the cerebro spinal fluid forces the arachnoid layer to herniate. The commonest clinical finding is a soft tissue swelling or tumour appearing on the head. We report the case of a 47 year old man, with a past history of a head injury in childhood. He presented complaining of loss of sensation in the right arm and deviation of the mouth, from which he recovered within an hour. Neuro imaging studies showed irregular destruction of the right temporal bone and hypodensity of the underlying brain tissue. Surgical operation and histological study of the bone removed showed that it was a leptomeningeal cyst, associated with a cerebral infarct at the site of an old skull fracture. A post traumatic leptomeningeal cyst in an adult patient is caused by a tear in the dura mater caused by a skull fracture during childhood. It may be associated with a cerebral infarct. It may present with only transient focal neurological symptoms.

Growing traumatic leptomeningeal cyst of the roof of the orbit presenting with unilateral exophthalmos

BACKGROUND Growing skull fractures rarely develop in the skull base region. To the best of our knowledge, only two similar cases have been reported in the English literature. This rare complication, which can occur even after a mild head injury, can produce exophthalmos and threaten the vision. METHODS The clinical and radiological findings of expanding leptomeningeal cysts extending into the orbit in nine patients referred to the department of Neurosurgery are presented. After appropriate investigations confirming the presence of the expansile retroglobal lesion, surgical exploration was performed via fronto-lateral or the preferred fronto-basal approach. The variable findings are denoted and the relevant literature is also reviewed. RESULTS Frontobasal head injuries play an important role in pathogenesis of these traumatic expansile leptomeningeal cysts. In this series of nine young girls, 6.65% (six out of nine) injuries happened in the first decade of life with an interval of 2 to 12 months (mean = 6.7, SD = 9.7). High-resolution coronal view computed tomography (CT) scanning with bone density window images, and high intensity cystic lesions visible on T2-weighted coronal MR images were diagnostic clues. CONCLUSIONS Growing fractures of the anterior skull base may complicate the natural course of healing of any minor frontobasal head injury, especially during childhood. Good quality imaging is mandatory in cases of progressive unilateral exophthalmos. Proper surgical intervention will lead to a good cosmetic result.

Traumatic leptomeningeal cyst in an adult: a case report and review of the literature

Background Traumatic leptomeningeal cyst as a complication of skull fractures was initially thought to occur primarily in the pediatric population. The occurrence of a traumatic leptomeningeal cyst in the adult population is rare. Case Description A lump in the right parietal region of this 53-year-old man prompted a computed tomography (CT) scan. The patient denied any symptoms and was in good health. Examination confirmed a firm, nontender, nonpulsatile mass in the right parietal region of the skull. The CT scan demonstrated a 4 × 3 cm area of irregular bone destruction involving both the inner and outer table of the skull. At operation a distinctly raised paper-thin outer table was noted, and underneath was a soft, tan-colored mass, which measured approximately 2 × 2 cm and was connected to the underlying brain through a 1 cm dural defect. The extradural portion of the mass was amputated, the dura repaired with a pericranium patch, the skull defect was repaired with a split thickness bone graft, and the final pathology was congruent with gliotic brain. Conclusion Although rare, this case demonstrates a traumatic leptomeningeal cyst in an adult.

Leptomeningeal cysts associated with traumatic cerebrospinal fluid rhinorrhea. Diagnostic value of scinticisternography.

✓ Nine instances of traumatic leptomeningeal cysts associated with rhinorrhea are described. The authors believe that the consequences of head trauma are responsible for both the rhinorrhea and the formation of leptomeningeal cysts, and that the scintigraphic demonstration of a leptomeningeal cyst may help in diagnosis when no overt rhinorrhea is present.