1/124. hyponatremia-induced metabolic encephalopathy caused by Rathke's cleft cyst: a case report.Rathke's cleft cysts are sometimes associated with aseptic meningitis or metabolic encephalopathy due to hyponatremia. We treated such a case manifest by lethargy, fever and electroencephalographic abnormalities. A 68-year-old man was admitted to our ward after experiencing general malaise, nausea and vomiting and then high fever and lethargy. On admission, he was drowsy and had nuchal rigidity and Kernig's sign. Physically, he was pale with dry, thickened skin. He had lost 5.0 kg of body weight in the last month. His serum sodium was 115 mEq/l. He had a low serum osmotic pressure (235 mOsmol/l) and a high urine osmotic pressure (520 mOsmol/l). His urine volume was 1200-1900 ml/24 h with a specific gravity of 1008-1015. The urine sodium was 210 mEq/l. He did not have an elevated level of antidiuretic hormone. Electroencephalograms showed periodic delta waves over a background of theta waves. With sodium replacement, the patient become alert and symptom free, and his electroencephalographic findings normalized. However, the serum sodium level did not stabilize, sometimes falling with a recurrence of symptoms. magnetic resonance imaging clearly delineated a dumbbell-shaped intrasellar and suprasellar cyst. The suprasellar component subsequently shrunk spontaneously and finally disappeared. An endocrinologic evaluation showed panhypopituitarism. The patient was given glucocorticoid and thyroxine replacement therapy, which stabilized his serum sodium level and permanently relieved his symptoms. A transsphenoidal approach was performed. A greenish cyst was punctured, and a yellow fluid was aspirated. The cyst proved to be simple or cubic stratified epithelium, and a diagnosis of Rathke's cleft cyst was made. The patient was discharged in good condition with a continuation of hormonal therapy. Rathke's cleft cyst can cause aseptic meningitis if the cyst ruptures and its contents spill into the subarachnoid space. Metabolic encephalopathy induced by hyponatremia due to salt wasting also can occur if the lesion injures the hypothalamus and pituitary gland.- - - - - - - - - - ranking = 1keywords = cleft cyst, cyst, suprasellar, cleft (Clic here for more details about this article) |
2/124. Expanding cyst following temporal lobectomy: an unusual complication of epilepsy surgery.Following anterior temporal lobectomy performed to control intractable complex partial seizures (CPS), it is rare to find a symptomatic cyst at the lobectomy site causing increased intracranial pressure and neurological deterioration. We report a 24-year-old lady who underwent anterior temporal lobectomy with extended amygdalohippocampectomy for CPS of temporal lobe origin. Ten months following the procedure, she developed a large expanding cyst at the temporal lobectomy site manifesting with recurrence of CPS, progressive focal neurological deficit and increased intracranial pressure. The patient underwent a repeat craniotomy, decompression of the cyst along with wide excision of the wall and fenestration of the arachnoid membrane into the basal cisterns. Following the procedure, the features of increased intracranial pressure and focal neurological deficit promptly improved and her seizures became better controlled. craniotomy and fenestration of a symptomatic iatrogenic cyst following temporal lobectomy results in clinical improvement, obviating the need for a permanent cystoperitoneal shunt.- - - - - - - - - - ranking = 0.18766978635913keywords = cyst (Clic here for more details about this article) |
3/124. Intracranial nasal dermoid sinus cyst associated with colloid cyst of the third ventricle. Case report and new concepts.A case of a 16-year-old male with both a nasal dermoid sinus cyst (NDSC) and a third ventricle colloid cyst is presented. The NDSC was excised via a single-stage combined intracranial-extracranial approach and the third ventricle colloid cyst was resected endoscopically. The pathogenetic theories of NDSC and third ventricle colloid cyst are discussed, and an embryological explanation for the simultaneous development of the two lesions in this patient is explored. This case is best classified among congenital developmental malformations in a category we propose to call 'anterior neuropore corridor defects.'- - - - - - - - - - ranking = 0.25022638181217keywords = cyst (Clic here for more details about this article) |
4/124. Transsphenoidal supradiaphragmatic intradural approach: technical note.Presellar extension of the bone window combined with removal of the sellar floor results in the transsphenoidal supradiaphragmatic intradural approach. One tuberculum sella meningioma and another suprasellar Rathke's cleft cyst confined to the pituitary stalk were removed via this approach. The presellar extension of the bone window was performed with the sublabial transseptal transsphenoidal technique. Furthermore, the dissection of the anterior intercavernous sinus, diaphragma sella, and arachnoid trabecula has allowed a wide surgical field of pre- and suprasellar areas and facilitates safe removal of lesions without significant surgical complications in selected cases.- - - - - - - - - - ranking = 0.13831891900069keywords = cleft cyst, cyst, suprasellar, cleft (Clic here for more details about this article) |
5/124. Successful management of sellar and suprasellar arachnoid cysts with stereotactic intracavitary irradiation: an expanded report of four cases.OBJECTIVE: Sellar and suprasellar arachnoid cysts may be asymptomatic or may cause headache, optic nerve compression, endocrine dysfunction, or hydrocephalus. We propose a minimally invasive treatment strategy when intervention is indicated. methods: Four patients with sellar and suprasellar arachnoid cysts presented with headache, visual compromise, and endocrine dysfunction. Two of the four patients previously had undergone unsuccessful surgical intervention. The imaging studies of two patients were diagnostic of an arachnoid cyst. RESULTS: All four patients underwent stereotactic intracavitary radiation with cyst regression and symptomatic improvement. In each patient, the optic chiasm was decompressed successfully. There were no complications from the procedure. CONCLUSION: Stereotactic intracavitary irradiation of arachnoid cysts proved to be safe and effective. The procedure obviated the need for open cyst fenestration or shunting.- - - - - - - - - - ranking = 0.2343425983146keywords = cyst, suprasellar (Clic here for more details about this article) |
6/124. Enterogenous cyst of the posterior fossa.We report the case of a 13-year-old boy who presented with deafness due to a posterior fossa cystic lesion which was surgically excised. Histological examination showed it to be an enterogenous cyst. These extremely rare lesions seldom occur within the neural axis.- - - - - - - - - - ranking = 0.12511319090609keywords = cyst (Clic here for more details about this article) |
7/124. Intraparenchymal pericatheter cyst. A rare complication of ventriculoperitoneal shunt for hydrocephalus.Intraparenchymal pericatheter cyst is rarely reported. Obstruction in the ventriculoperitoneal shunt leads to recurrence of hydrocephalus, signs of raised intracranial pressure and possibly secondary complications. Blockage of the distal catheter can result, unusually, in cerebrospinal fluid oedema and/or intraparenchymal cyst around the ventricular catheter which may produce focal neurological deficit. We report two cases of distal catheter obstruction with formation of cysts causing local mass effect and neurological deficit. Both patients had their shunt system replaced, which led to resolution of the cyst and clinical improvement. One patient had endoscopic exploration of the cyst which confirmed the diagnosis made on imaging studies. magnetic resonance imaging was more helpful than computed tomography in differentiating between oedema and collection of cystic fluid. Early recognition and treatment of pericatheter cyst in the presence of distal shunt obstruction can lead to complete resolution of symptoms and signs.- - - - - - - - - - ranking = 0.22937418332782keywords = cyst (Clic here for more details about this article) |
8/124. Rathke's cleft cyst with large frontal extension: unusual shape and pathomechanism of its formation.The patient was a 62 year old woman who presented with a visual field defect. Magnetic resonance images showed an intra-and supra-sellar low intensity mass on T1 weighted images. The preoperative diagnosis was craniopharyngioma, Rathke's cleft cyst (RCC) or arachnoid cyst. The patient underwent transsphenoidal surgery & the pathological diagnosis was RCC.We conclude that although RCC has a round, ovoid or dumb-bell shaped configuration, it may present a unusual shape in cases with preconditions, as were seen in our patient.- - - - - - - - - - ranking = 0.66941243770261keywords = cleft cyst, cyst, cleft (Clic here for more details about this article) |
9/124. Rathke's cleft cyst associated with hypophysitis: MRI.We report a symptomatic Rathke's cleft cyst associated with hypophysitis in a 61-year-old woman. We demonstrate the MRI features and discuss the pathophysiology. To the best of our knowledge this is the first description of a Rathke's cleft cyst shrinking after high-dose steroid therapy.- - - - - - - - - - ranking = 0.77827228706192keywords = cleft cyst, cyst, cleft (Clic here for more details about this article) |
10/124. Extradural endodermal cyst of posterior fossa: case report, review of the literature, and embryogenesis.OBJECTIVE AND IMPORTANCE: Posterior fossa endodermal cysts are rare. They are located in the midline, in ventral or ventrolateral locations, or intrinsic to the neural axis. Accordingly, various theories of embryogenesis have been proposed. We report the first case of an extradural, dorsolaterally situated endodermal cyst. CLINICAL PRESENTATION: An adult male patient presented with a short history of headache and cerebellar ataxia. neuroimaging revealed an extra-axial cystic posterior fossa mass. INTERVENTION: An entirely extradural cyst was found and was totally excised. immunohistochemistry confirmed the diagnosis of endodermal cyst. CONCLUSION: The extradural, dorsal location of the endodermal cyst suggests gaps at the cranial end of the notochord causing ectodermal-endodermal adhesions during early gastrulation and the persistence of endodermal remnants in the dorsal mesenchyme of the blastemal cranium. The literature is reviewed, and proposed theories of embryogenesis are discussed.- - - - - - - - - - ranking = 0.20852198484348keywords = cyst (Clic here for more details about this article) |
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