Post-traumatic intradiploic leptomeningeal fistula and cyst.
A 59 year old female patient presented with ataxia and difficulty in walking. The neurological examination revealed right homonymous hemianopia and ataxia. Radiographic evaluation revealed a large occipital intradiploic cyst mainly in the left suboccipital area. There was also moderate hydrocephalus and encephalomalacia of the left occipital pole. Bone window studies also demonstrated a growing fracture extending from the upper pole of the cyst to the vertex. Both pathologies were attributed to child abuse the patient suffered when she was a child. At first surgery, decompression of the cerebellum was followed by duroplasty and acrylic cranioplasty to the posterior cranial fossa. A month later, a shunt had to be inserted for hydrocephalus. At 7 months postoperatively, the patient is well and free of any symptoms or recurrence.
Açikgöz
Bektaş
B
Bayindir Medical Centre, Department of Neurosurgery, Ankara, Turkey. bync@bayindirtip.com.tr
Tekkök
Ismail H
IH
D016080:Arachnoid Cysts / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006259:Craniocerebral Trauma / Q000150:complications* / Q000601:surgery; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008578:Meninges / Q000293:injuries* / Q000473:pathology*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed