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A congenital abnormality masquerading as encephalitis in an 11-year-old girl

D Horner1, D Jones, S Carley

  • 1Booth Hall Childrens Hospital, Charlestown, Manchester, UK. danhorner@doctors.net.uk

Emergency Medicine Journal : EMJ
|March 23, 2010
PubMed

Insights

A rare pediatric craniopharyngioma presented acutely, mimicking encephalitis. Early neuroimaging is crucial for diagnosing brain tumors in children with unclear symptoms.

Area of Science:

  • Pediatric Neurosurgery
  • Neuro-oncology
  • Pediatric Neurology

Background:

  • Craniopharyngiomas are the most common non-glial tumors in children, typically presenting with gradual visual, growth, or endocrine issues.
  • Classic symptoms include visual field defects, growth abnormalities, and endocrine disturbances.

Observation:

  • An 11-year-old girl presented with an acute confusional state and no localizing signs, initially treated for encephalitis.
  • Neuroimaging revealed a large craniopharyngioma causing acute hydrocephalus and frontal lobe compression.

Findings:

  • Urgent reservoir drainage of the cystic craniopharyngioma led to immediate symptom resolution.
  • This case underscores the importance of prompt neuroimaging in pediatric diagnostic uncertainty.

Implications:

  • A high index of suspicion for intracranial mass lesions is vital in children, even with atypical presentations.
  • Early cerebral imaging can significantly improve outcomes for pediatric brain tumors.

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