[Cerebellar cyst associated with cytoarchitectonic abnormalities in the cerebellar cortex]

The patient, 64-year-old female, had episode of sudden attack of severe vertigo, headache, nausea, and vomiting which lasted for about twenty minutes on May 20th in 1980. She had hypertension, polyp of stomach, diverticuli of duodenum in her past history. Neurological examination on her admission revealed fine horizontal nystagmus on bilateral gaze and slight clumsy movement on left F-N test. On plain skull and cervical X-P, atlanto-occipital fusion and Klippel-Feil syndrome (C2-C3 fusion) were seen. Plain CT scanning revealed a large cystic lesion which extended from the vermis to the left cerebellar hemisphere. No enhanced area was seen. The forth ventricle was seemed to be enlarged. And the left-sided dorsal part of the forth ventricle attached to the cyst. Metrizamide CT cisternogram showed there was no direct communication between them. Angiographically, the vertebrobasilar arteries were noted sclerotic changes and poor vascularities in the left cerebellar hemisphere was noted. On opening the dura during surgery, the left cerebellar hemisphere appeared bulging state and the bilateral cerebellar tonsils were hypoplastic. Outer thin membrane of the cyst was removed. The cyst has no communication with the subarachnoid space as well as with the forth ventricle. The cystic fluid was slightly yellowish, but had no Froin's sign. Reddish-gray color nodular area, which seemed to be similar to mural nodule macroscopically, was noted in the area of inner surface of the cyst. This part was removed. Histological findings of this area showed abnormal architecture with malarranged layer of cerebellar cortex.(ABSTRACT TRUNCATED AT 250 WORDS)