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[Aseptic meningitis caused by the rupture of an epidermoid cyst]

A Pampliega-Pérez1, C Martín-Estefanía, M Caballé-Tura

  • 1Servicio de Neurología, Hospital General Universitario de Alicante, Alicante, España. apampliega@yahoo.com

Revista De Neurologia
|August 26, 2003
PubMed
Abstract

Insights

Ruptured epidermoid cysts can cause aseptic meningitis, a rare condition. Corticosteroid therapy can alleviate symptoms, but complications like hydrocephalus may still occur due to cerebrospinal fluid reabsorption issues.

Area of Science:

  • Neurology
  • Neurosurgery
  • Pathology

Background:

  • Epidermoid cysts are uncommon tumors, and their rupture can lead to aseptic meningitis, particularly post-operatively.
  • Spontaneous aseptic meningitis secondary to epidermoid cyst rupture is a rare clinical presentation.

Observation:

  • A 36-year-old male presented with symptoms suggestive of meningitis following two prior surgeries for a cerebellopontine angle epidermoid cyst.
  • Initial antibiotic therapy was ineffective; subsequent MRI revealed suspected tumor recurrence and meningeal enhancement.
  • Corticosteroid treatment provided temporary symptom relief, but the patient later developed tetraventricular hydrocephalus requiring surgical intervention.

Findings:

  • The case highlights a subacute presentation of aseptic meningitis caused by a ruptured epidermoid cyst.
  • Corticosteroid therapy demonstrated efficacy in managing the inflammatory meningitis symptoms.
  • Tetraventricular hydrocephalus emerged as a significant complication, indicating disruption of cerebrospinal fluid dynamics.

Implications:

  • This case underscores the importance of considering ruptured epidermoid cysts in the differential diagnosis of aseptic meningitis, even with a history of surgery.
  • While corticosteroids can be beneficial for symptom management, potential complications such as hydrocephalus necessitate vigilant monitoring and appropriate neurosurgical management.
  • Understanding the pathophysiology of cerebrospinal fluid reabsorption disturbances is crucial for managing such rare neurological complications.

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