Bobble-head doll syndrome with supra-sellar arachnoid cyst

2020 ◽  
pp. practneurol-2020-002666
Author(s):  
Done Indira Priya ◽  
Ramkumar Sugumaran ◽  
Narayan Sunil K ◽  
Chauhan Supriya
Keyword(s):  
Arachnoid Cyst ◽  
Endoscopic Third Ventriculostomy ◽  
Head Movements ◽  
Third Ventriculostomy ◽  
Functional Disorder ◽  
Detailed Evaluation ◽  
Suprasellar Arachnoid Cyst ◽  
Cyst Fenestration

A 19-year-old woman reported progressively worsening involuntary head movements since the age of 7. She had visited multiple hospitals and been labelled as having a functional disorder. Detailed evaluation identified a large supra-sellar arachnoid cyst with hydrocephalus. We made a diagnosis of bobble-head doll syndrome, which is only very rarely associated with suprasellar arachnoid cyst. Her symptoms improved rapidly following endoscopic third ventriculostomy with cyst fenestration and gradual decompression of the ventricles. Clearly, not all suppressible movements should be labelled as psychogenic.

Institutional experience of endoscopic suprasellar arachnoid cyst fenestration

2013 ◽  
Vol 29 (8) ◽  
pp. 1345-1347 ◽  
Author(s):  
Elias Rizk ◽  
Joshua J. Chern ◽  
Christine Tagayun ◽  
R. Shane Tubbs ◽  
Todd Hankinson ◽  
...  
Keyword(s):  
Arachnoid Cyst ◽  
Institutional Experience ◽  
Suprasellar Arachnoid Cyst ◽  
Cyst Fenestration

Suprasellar arachnoid cyst resulting in the syndrome of inappropriate antidiuretic hormone secretion

2010 ◽  
Vol 6 (5) ◽  
pp. 486-488 ◽  
Author(s):  
Alexandra D. Beier ◽  
Samuel H. Cheshier ◽  
Aabir Chakraborty ◽  
Peter Dirks
Keyword(s):  
Antidiuretic Hormone ◽  
Arachnoid Cyst ◽  
Pediatric Population ◽  
Hormone Secretion ◽  
Fluid Restriction ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Hypothalamic Pituitary Axis ◽  
Suprasellar Arachnoid Cyst ◽  
Cyst Fenestration

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is occasionally seen after hypothalamic injury or dysfunction, although it typically occurs in association with other endocrine disturbances. It is has never been described as a presenting feature of a suprasellar arachnoid cyst (SAC) in the pediatric population. The authors describe the case of an enlarging SAC resulting in SIADH as the only presenting feature, with an otherwise normal hypothalamic-pituitary axis. An SAC was diagnosed in utero in this 5-month-old girl who had a normal functioning hypothalamic-pituitary axis on presentation. Because of cyst enlargement and hydrocephalus, the patient was scheduled for surgery; however, preoperative labs revealed SIADH. After stabilizing the serum sodium concentration with fluid restriction and the administration of 3% sodium chloride, the patient underwent endoscopic cyst fenestration. Postoperatively, she had complete resolution of the SIADH. Syndrome of inappropriate antidiuretic hormone secretion as the presenting symptom of an SAC has not been previously described. In the aforementioned patient, the proposed mechanism for SIADH was enlargement of the suprasellar arachnoid cyst causing compression of the supraoptic and paraventricular nuclei and thus overstimulating the secretion of arginine vasopressin, which resulted in SIADH. The association of SIADH with an SAC is reportable, as is the resolution of the SIADH via cyst fenestration. The authors suggest that SIADH is an uncommon presenting feature of SACs and that syndrome resolution is possible with cyst decompression.

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