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[Cerebellar abscess caused by an occipital dermal sinus in an infant]
1Academisch Ziekenhuis Vrije Universiteit, afd. Neurochirurgie, Amsterdam.
Insights
An infected occipital dermal sinus caused obstructive hydrocephalus and cerebellar abscesses in an infant. Surgical removal and antibiotics successfully treated this rare congenital condition.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Congenital dermal sinus tracts are rare malformations along the craniospinal axis.
- These tracts can lead to serious intracranial infections, such as abscesses.
- Occipital dermal sinuses are particularly associated with posterior fossa pathologies.
Abstract:
A 7.5-month-old girl was admitted with the clinical signs and symptoms of raised intracranial pressure. This was caused by an obstructive hydrocephalus, due to cerebellar abscesses induced by an infected contiguous complete occipital dermal sinus. Staphylococcus aureus was cultured. The patient was treated by radical excision of the dermal sinus and the abscesses after initial external drainage of the lateral cerebral ventricle, followed by systemic antibiotic therapy. The different types of dermoid cysts of the posterior cranial fossa are described. Early detection of congenital dermal abnormalities along the craniospinal axis by routine examination of newborns is prognostically important. Computerised tomography or magnetic resonance imaging are the methods of choice for further investigation of suspect dermal lesions.