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Postoperative cerebellar herniation in a large intrapetrous aneurysmal bone cyst
D P Muzumdar1, A Goel, R Mistry
1Department of Neurosurgery, King Edward VII Memorial Hospital and Seth G.S. Medical College, Parel, Mumbai 400012, India.
Summary
Aneurysmal bone cysts in the petrous bone are rare. This case highlights successful surgical resection and an unusual cerebellar herniation that may have sealed a cerebrospinal fluid fistula.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Petrous bone aneurysmal bone cysts are rare, typically presenting in younger individuals.
- Surgical resection is the primary treatment modality for symptomatic lesions.
- Complete tumor removal can be challenging due to the complex anatomy of the petrous bone.
Observation:
- An 18-year-old male presented with a large petrous bone tumor.
- Surgical intervention involved radical resection of the aneurysmal bone cyst.
- A significant dural defect was noted in the posterior petrous bone post-resection.
Findings:
- Post-operative MRI confirmed complete tumor resection.
- Cerebellar herniation into the surgical defect was observed.
- This herniation potentially contributed to the closure of a cerebrospinal fluid fistula.
Implications:
- This case demonstrates a rare presentation of an aneurysmal bone cyst in the petrous bone.
- The unexpected cerebellar herniation served a beneficial role in managing a post-operative complication.
- Findings suggest a potential mechanism for spontaneous cerebrospinal fluid fistula closure in specific surgical contexts.