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Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child
Muhammad Faisal Khilji1, Niranjan Lal Jeswani1, Rana Shoaib Hamid2
1Department of Emergency Medicine, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, 123 Muscat, Oman.
Insights
This case report details a rare instance of a pediatric brain arachnoid cyst associated with spontaneous subdural hygromas. Surgical intervention led to a successful recovery, highlighting a unique neurological presentation in a child.
Area of Science:
- Pediatric Neurosurgery
- Neurology
- Radiology
Background:
- Arachnoid cysts of the brain are common in children.
- Association with spontaneous subdural hygroma is rare.
- Presents a unique case in a pediatric patient without trauma history.
Purpose of the Study:
- To report a rare case of pediatric arachnoid cyst with subdural hygroma.
- To describe the clinical presentation, diagnostic findings, and management.
- To emphasize the importance of considering rare associations in pediatric neurosurgery.
Main Methods:
- Case presentation of a nine-year-old boy with neurological symptoms.
- Diagnostic imaging using Magnetic Resonance Imaging (MRI).
- Surgical management including craniectomy and burr hole drainage.
Main Results:
- MRI revealed a large left temporal arachnoid cyst and bilateral frontoparietal subdural hygromas.
- Surgical drainage of the cyst and hygromas was performed.
- Histopathology confirmed arachnoid cyst with subdural cerebrospinal fluid collection.
Conclusions:
- This case highlights a rare association between brain arachnoid cysts and subdural hygromas in children.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes.
- Further research may elucidate the underlying pathophysiology of this rare condition.
Abstract:
Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye. MRI (magnetic resonance imaging) of the brain showed left temporal extra-axial cystic lesion of 5.40 × 4.10 cm in size, representing arachnoid cyst, with bilateral frontoparietal subdural hygromas. Cyst was partially drained through left temporal craniectomy and subdural hygromas were drained through bilateral frontal burr holes. Postoperatively the child recovered uneventfully and was discharged on the seventh postoperative day. Histopathology proves it to be arachnoid cyst of the brain with subdural CSF (cerebrospinal fluid) collection or hygroma.
