Spontaneous leaking craniopharyngioma causing preoperative chemical meningitis

Patnaik, Ashis; Mahapatra, Ashok Kumar; Sarkar, Saurav; Samal, Dillip Kumar

doi:10.4103/2152-7806.180466

Cited by 6 publications

(12 citation statements)

References 10 publications

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“…Aseptic meningitis due to rupture of an intracranial tumor is a relatively well-known event, 34 but the spontaneous rupture of CPs causing aseptic meningitis is even more rare with 20 reported patients in the English literature ( Supplementary Table S1 [online only]). 5 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 Such clinical scenario comprises the most frequent clinical presentation of spontaneous CP rupture, which also includes improvement of neurological deficits, 11 27 30 asymptomatic rupture documented on follow-up imaging, 25 31 and vasospasm. 29 There is a considerable increase in spontaneous CP rupture diagnosis after the 1980s, which is associated with the advent of CT and MRI.…”

Section: Discussionmentioning

confidence: 99%

“…Myriad clinical presentations of patients with aseptic meningitis due to CP rupture are nonspecific and believed to occur by the chemical effect of cholesterol into the subarachnoid space. 8 15 16 Diagnosis is generally suggested by an altered CSF analysis (pleocytosis and high protein levels) with negative culture. 14 16 17 18 20 It is worth mentioning that CSF may be abnormal in as much as 80% of the patients having tumors greater than 3 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“… 8 15 16 Diagnosis is generally suggested by an altered CSF analysis (pleocytosis and high protein levels) with negative culture. 14 16 17 18 20 It is worth mentioning that CSF may be abnormal in as much as 80% of the patients having tumors greater than 3 cm in diameter. 4 …”

Section: Discussionmentioning

confidence: 99%

“… 8 To date, less than 35 cases of spontaneous CP rupture have been reported in the English literature. 5 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Herein, we present a report of an adolescent with a multicystic CP who experienced an episode of aseptic meningitis due to spontaneous rupture of the ventricular cyst, which contained an Ommaya catheter.…”

Section: Introductionmentioning

confidence: 99%

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Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

et al. 2022

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Craniopharyngiomas (CPs) are benign tumors that are believed to arise from embryonic remnants of the Rathke pouch epithelium. Herein, we report a case of aseptic meningitis due to spontaneous rupture of multicystic CP, which contained an Ommaya catheter. A 19-year-old boy was admitted to the hospital with a 4-day history of acute severe headache after strenuous physical exercise followed by altered sensorium, fever, and neck stiffness. Cerebrospinal fluid (CSF) analysis revealed marked pleocytosis and elevated protein levels. CSF culture was otherwise negative. Cyst reduction on subsequent imaging confirmed the diagnosis. The patient received intravenous steroid therapy and was discharged asymptomatic. This is a rare evolution of a multicystic CP, which was previously treated with intracystic therapy and had an Ommaya catheter. Clinicians should be aware of spontaneous CP rupture and look actively for the occurrence of cholesterol crystals or elevated CSF levels of cholesterol as well as prompt follow-up imaging.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

et al. 2022

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“…During the fever episode, the cultures were negative, so the diagnosis of aseptic meningitis was made, with the limitation of not having carried out studies for viral aetiologies. Cases of chemical meningitis have been reported due to rupture of the cystic content of the craniopharyngioma30 31; however, they usually occur prior to the procedure. In our case, there was no reported rupture of the contents during the resection, nor did the patient present a cystic lesion after the procedure since the resection was complete, so the probability that the episode of meningitis is associated with the craniopharyngioma content is low.…”

Section: Discussionmentioning

confidence: 99%

Adipsic diabetes insipidus secondary to craniopharyngioma resection

Pérez¹,

Millán

Naranjo

et al. 2019

BMJ Case Rep

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Adipsic diabetes insipidus is an infrequent disease which may be associated with craniopharyngioma. It may be secondary to the tumour’s extension, as well as to resection of the mass. We present the case of a 24-year-old woman with a history of delayed puberty and hypothyroidism, but no prior study reports. She consulted due to a headache with warning signs associated with altered visual acuity. Brain MRI was performed which showed signs of a non-adenomatous lesion with suprasellar and hypothalamic extension. Following transcranial surgery, she developed diabetes insipidus criteria, with absence of thirst documented during the hospitalisation. The histopathological findings confirmed the diagnosis of craniopharyngioma. The patient was treated with desmopressin and received recommendations regarding rehydration according to the quantification of losses, with electrolyte stabilisation.

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Chemical meningitis from a leaking craniopharyngioma: a case report

Hakizimana¹,

Poulsgaard

Fugleholm

2018

Acta Neurochir

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Recurrent chemical meningitis from cyclic leakage of cyst content from a craniopharyngioma is a rare phenomenon. Here, we report a case of leaking cystic craniopharyngioma presenting with recurrent episodes of sterile meningitis, depression, and paranoia. The diagnosis after an initial craniotomy and exploration was hypophysitis. Signs and symptoms were not alleviated by puncture and biopsy of the tumour but they disappeared after complete resection with a final histological diagnosis of craniopharyngioma.

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Spontaneous leaking craniopharyngioma causing preoperative chemical meningitis

Cited by 6 publications

References 10 publications

Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

Adipsic diabetes insipidus secondary to craniopharyngioma resection

Chemical meningitis from a leaking craniopharyngioma: a case report

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