An infantile case of posterior fossa arachnoid cyst presenting with marked engorgement of contralateral supraorbital vein

Background. Primary hyperparathyroidism in childhood is a very rare entity, often being diagnosed late after the onset of its presenting symptoms. It most commonly affects patients in their fourth decade of life and beyond. The inclusion of primary hyperparathyroidism in the differential diagnosis is necessary when evaluating patients presenting with nonspecific symptoms such as polyuria, fatigue, weight loss, abdominal pain, nausea, and vomiting.Methods. We report the case of an eleven-year-old girl presenting with three years history of headaches, visual disturbance, along with episodes of emotional lability. Neuroimaging confirmed a large posterior fossa arachnoid cyst. It was decided to manage this lesion conservatively with surveillance. Only after further hospital admissions with recurrent loss of consciousness, dizziness, and nausea to add to her already existing symptoms, a full biochemical and endocrine assessment was performed to look for more specific causes for her presentation. These pointed to a diagnosis of primary hyperparathyroidism.Conclusions. The inclusion of primary hyperparathyroidism in the differential diagnosis should be considered when evaluating paediatric patients presenting with nonspecific (neurological, gastrointestinal, and renal) symptoms in order to establish a prompt diagnosis of the disorder and to avoid severe complications of prolonged hypercalcaemia and end-organ damage.

Download Full-text

T11/T12 ossification of the yellow ligament contributing to thoracic myelopathy in patient with posterior fossa arachnoid cyst and acquired incidental Chiari I malformation/syrinx

Surgical Neurology International ◽

10.25259/sni_404_2021 ◽

2021 ◽

Vol 12 ◽

pp. 246

Author(s):

Toshiya Aono ◽

Hideaki Ono ◽

Takeo Tanishima ◽

Akira Tamura ◽

Isamu Saito

Keyword(s):

Lower Extremity ◽

Posterior Fossa ◽

Arachnoid Cyst ◽

Cord Compression ◽

Chiari I Malformation ◽

Case Description ◽

Thoracic Myelopathy ◽

Chiari I ◽

New Onset

Background: Thoracic ossification of the yellow ligament (OYL) may contribute to myelopathy. In the case presented, the patient additionally had a chronic posterior fossa arachnoid cyst with an acquired Chiari I malformation and cervicothoracic syrinx. Case Description: A 40-year-old female with a posterior fossa arachnoid cyst found 17 years ago, and newly acquired Chiari I malformation (tonsils down 5 mm) with a C7-T5 syrnix, presented with the new onset of lower extremity myelopathy. The MR documented marked dorsolateral cord compression due to T11/T12 OYL. Six months following a laminectomy for resection of OYL, the patient was asymptomatic. Conclusion: In patients presenting with the new onset of lower extremity myelopathy, evaluation of the complete neuraxis may be warranted. Here, the patient has an unchanged posterior fossa arachnoid cyst with an acquired Chiari I malformation/C7-T5 syrinx. However, the patient’s symptoms were fully attributed to the MR-documented T11/T12 OYL that was successfully resected.

Download Full-text

Posterior fossa arachnoid cyst demonstrated by ultrasound

Journal of Clinical Ultrasound ◽

10.1002/jcu.1870100212 ◽

1982 ◽

Vol 10 (2) ◽

pp. 88-90 ◽

Cited By ~ 1

Author(s):

E. Steve Roach ◽

D. Wayne Laster ◽

Thomas E. Sumner ◽

Frank M. Volberg

Keyword(s):

Posterior Fossa ◽

Arachnoid Cyst

Download Full-text

Cyst-ventricle stent as primary or salvage treatment for posterior fossa arachnoid cysts

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.2.peds10457 ◽

2011 ◽

Vol 7 (5) ◽

pp. 549-556 ◽

Cited By ~ 7

Author(s):

Daniel H. Fulkerson ◽

Todd D. Vogel ◽

Abdul A. Baker ◽

Neal B. Patel ◽

Laurie L. Ackerman ◽

...

Keyword(s):

Posterior Fossa ◽

Arachnoid Cyst ◽

Arachnoid Cysts ◽

Morbidity Rate ◽

Initial Symptom ◽

Salvage Procedure ◽

The Third ◽

First Line Therapy ◽

Posterior Fossa Cyst

Object The optimal treatment of symptomatic posterior fossa arachnoid cysts is controversial. Current options include open or endoscopic resection, fenestration, or cyst-peritoneal shunt placement. There are potential drawbacks with all options. Previous authors have described stenting a cyst into the ventricular system for supratentorial lesions. The current authors have used a similar strategy for posterior fossa cysts. Methods The authors performed a retrospective review of 79 consecutive patients (1993–2010) with surgically treated intracranial arachnoid cysts. Results The authors identified 3 patients who underwent placement of a stent from a posterior fossa arachnoid cyst to a supratentorial ventricle. In 2 patients the stent construct consisted of a catheter placed into a posterior fossa arachnoid cyst and connecting to a lateral ventricle catheter. Both patients underwent stent placement as a salvage procedure after failure of open surgical fenestration. In the third patient a single-catheter cyst-ventricle stent was stereotactically placed. All 3 patients improved clinically. Two patients remained asymptomatic, with radiographic stability in a follow-up period of 1 and 5 years, respectively. The third patient experienced initial symptom resolution with a demonstrable reduction of intracystic pressure. However, he developed recurrent headaches after 2 years. Conclusions Posterior fossa cyst–ventricle stenting offers the benefits of ease of surgical technique and a low morbidity rate. It may also potentially reduce the incidence of shunt-related headaches by equalizing the pressure between the posterior fossa and the supratentorial compartments. While fenestration is considered the first-line therapy for most symptomatic arachnoid cysts, the authors consider cyst-ventricle stenting to be a valuable additional strategy in treating these rare and often difficult lesions.

Download Full-text

Microsurgical treatment of a large posterior fossa arachnoid cyst

Archives of Pediatric Neurosurgery ◽

10.46900/apn.v2i3(september-december).59 ◽

2020 ◽

Vol 2 (3(September-December)) ◽

pp. e592020

Author(s):

Leopoldo Mandic Ferreira Furtado ◽

José Aloysio da Costa Val Filho ◽

François Dantas ◽

Camila Moura De Sousa

Keyword(s):

Posterior Fossa ◽

Arachnoid Cyst ◽

Motor Development ◽

Fourth Ventricle ◽

Open Surgery ◽

Surgical Strategies ◽

Development Delay ◽

Microsurgical Resection ◽

Cystoperitoneal Shunting ◽

Endoscopic Fenestration

Introduction: Arachnoid cysts are fluid-filled malformations of the arachnoid tissue. A prevalence in children of 2,6% has been reported[2,3]. Surgical strategies of treatment include open surgery with cyst wall excision , endoscopic fenestration or cystoperitoneal shunting[1,4]. Methods: In this video case, we described the case of a 1 year and 7 months old child who presented with motor development delay, unable to walk, who underwent microsurgical resection of a large posterior fossa arachnoid cyst and communication with the fourth ventricle. Conclusion: Microsurgery approach provides a safe anatomic control over the cyst and the recognition of floor of the fourth ventricle.

Download Full-text