Post-traumatic intradiploic leptomeningeal fistula and cyst. |
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Authors: | Bekta? A?ikg?z Ismail H Tekk?k |
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Institution: | Bayindir Medical Centre, Department of Neurosurgery, Ankara, Turkey. bync@bayindirtip.com.tr |
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Abstract: | A 59 year old female patient presented with ataxia and difficulty in walking. The neurological examination revealed right homonymous hemianopia and ataxia. Radiographic evaluation revealed a large occipital intradiploic cyst mainly in the left suboccipital area. There was also moderate hydrocephalus and encephalomalacia of the left occipital pole. Bone window studies also demonstrated a growing fracture extending from the upper pole of the cyst to the vertex. Both pathologies were attributed to child abuse the patient suffered when she was a child. At first surgery, decompression of the cerebellum was followed by duroplasty and acrylic cranioplasty to the posterior cranial fossa. A month later, a shunt had to be inserted for hydrocephalus. At 7 months postoperatively, the patient is well and free of any symptoms or recurrence. |
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