A supratentorial, hemorrhagic, intraparenchymal epidermoid cyst

Fox, Benjamin D.; Smitherman, Sheila M.; Amhaz, Hassan; Ruiz, Mònica; Rouah, Emilie; Radaideh, Majdi; Ehni, Bruce L.

doi:10.1016/j.jocn.2008.04.033

Cited by 18 publications

(15 citation statements)

References 22 publications

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“…Sugere-se que a ruptura espontânea do tumor, ou a manipulação cirúrgica do mesmo, promova a liberação de produtos como queratina e colesterol no espaço subaracnóide, culminando em reações irritativas sofridas pelo tecido cerebral e pelas meninges, caracterizando uma meningite química 2,3,4,7,10 . Essas reações inflamatórias geram mudanças na dinâmica liquórica, o que pode evoluir para hidrocefalia, como o caso citado neste trabalho 3,8 . Além disso, a aracnoidite nessas situações pode evoluir para alterações focais em córtex, vias tronculares, o que repercute clinicamente em déficits focais.…”

Section: Discussionunclassified

Meningite de Mollaret

Veríssimo¹,

Júnior²,

Cunha³

et al. 2018

jbnc

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Introdução: Meningite de Mollaret consiste em uma forma de meningite asséptica, sendo considerada uma patologia rara, haja visto a revisão literária mundial apresentar aproximadamente 50 casos descritos até o momento. Objetivo: Descrição de caso de meningite asséptica decorrente de lesão expansiva epidermóide. Método: Mulher submetida à ressecção retrossigmoidéia de tumor epidermóide em ângulo ponto-cerebelar a direita evoluindo sem déficits no pós-operatório imediato, mas evoluindo, no pós-operatório tardio, com meningismo e deficit de nervos cranianos contralaterais à lesão primária. Exames de propedêutica liquórica evidenciaram meningite sem crescimento de microorganismos. Discussão: A cascatainflamatória sistêmica desencadeada por essa patologia pode gerar um estado toxêmico, assemelhando-se clinicamente a meningite bacteriana. O estudo liquórico não evidencia agente causador, a despeito da elevação de polimorfonucleares e a redução da glicorraquia. O risco de desenvolver meningite asséptica pode ser reduzido, evitando-se contaminação do conteúdo cístico no espaço subaracnóide, removendo cuidadosamente todo tecido cístico e administrando corticoterapia no perioperatório. Conclusão: Meningite asséptica é uma patologia rara, sem consenso a respeito de seu manejo, justificando a necessidade de acúmulo de conhecimentos a partirde relatos de casos em todo o mundo

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Section: Discussionunclassified

Meningite de Mollaret

Veríssimo¹,

Júnior²,

Cunha³

et al. 2018

jbnc

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“…Resection of these lesions are done to protect the patient from mass effect on intracranial mass, abscess formation and to avoid potential complications such as bleeding and malignant transformation of IEIC [1] , [23] , [24] .…”

Section: Discussionmentioning

confidence: 99%

Intradiploic epidermoid cyst with intracranial hypertension syndrome: Report of two cases and literature review

Moreira-Holguín¹,

Medélez-Borbonio²,

Quintero-Lopez³

et al. 2015

International Journal of Surgery Case Reports

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HighlightsEpidermoid cysts are benign tumors -IEIC-that originate in the spine or intracraneally.Intradural compose 75% of epidermoid cysts and 25% are extradural in the diploic space—IEIC.These benign lesions although they are of low incidence, are seen very rarely in intradiploic locations and above all, of significant size, may produce significant mass effect in patients, which was initially tolerated because of its slow growth, however, they may become decompensate and cause intracranial hypertension syndrome.

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“…The hemorrhagic pattern with a horizontal interface separating the fluid into 2 layers is the result of sedimentation of red blood cells into a cerebrospinal fluid-like fluid. [8][9][10][11] The nodular signal intensity was attributed to the mixture of keratin with differently aged hemorrhage and granulation tissue. The dependent layer consisted of intact red blood cells containing methemoglobin, whereas the intermediate signal intensity on both T1-weighted and T2-weighted images was due to the opposed effects of intracellular methemoglobin (short T1, short T2) and high water content (long T1, long T2).…”

Section: Discussionmentioning

confidence: 99%

Spontaneously Hemorrhagic Epidermoid Cyst and Arachnoid Cyst Mimicking One Another

Ren

Lin

et al. 2011

Neurosurgery Quarterly

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Objective and Importance: The clinical and radiographic presentations of epidermoid cyst (EC) and arachnoid cyst (AC) are distinct for most cases. We present 2 cases with spontaneously intracystic hemorrhage illustrating the occasional difficulty one can encounter in distinguishing EC and AC.Clinical Presentation: Patient 1 is a woman who presented with left facial numbness, headache, and ataxia. Computerized tomography presented with an isodensity, whereas magnetic resonance image (MRI) presented with short T1 and long T2 signals with a fluid-fluid level. Patient 2 is a woman who presented with vertigo, numbness in the left face and tongue. Computerized tomography presented with hyperdensity, whereas MRI presented with homogeneous short T1 and short T2 signals.Intervention: Patient 1 was initially diagnosed with EC with spontaneous intracystic hemorrhage. Operative and pathologic findings revealed AC. Patient 2 was initially diagnosed with AC. However, 4 months later, the lesion presented itself with an enlarged cyst with nodules inside, indicating the diagnosis of EC.Conclusions: To differentiate between EC and AC with spontaneously intracystic hemorrhage is sometimes difficult. However, some features facilitate the differentiation. Fluid-fluid levels on MRI, especially on T2-weighted images, indicate the diagnosis of AC, whereas nodular signals in the background of hematoma indicate the diagnosis of EC. Operative findings of cheese-like content and white, thick capsules with or without granulation tissue adhesive to the peripheral tissue indicate EC, whereas transparent arachnoid-like capsules without solid content indicate AC. Microscopic examination will confirm the diagnoses.

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A supratentorial, hemorrhagic, intraparenchymal epidermoid cyst

Cited by 18 publications

References 22 publications

Meningite de Mollaret

Meningite de Mollaret

Intradiploic epidermoid cyst with intracranial hypertension syndrome: Report of two cases and literature review

Spontaneously Hemorrhagic Epidermoid Cyst and Arachnoid Cyst Mimicking One Another

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