Arachnoid Cyst with Intracystic Hemorrhage in a Child: Need For Vigilance and Prompt Treatment (P6.324)

摘要: Intracranial arachnoid cysts (AC) constitute one percent of all intracranial lesions, most frequently identified in children and mostly located the middle cranial fossa. They are typically asymptomatic benign non communicating collections cerebrospinal fluid that occur relation to subarachnoid space. Up 27 per cent cases may be complicated by subacute or chronic subdural hematoma (SDH) hemorrhage with minor head trauma, reportedly up 16 weeks post trauma. Neurological symptoms can acute non-localizing. Most common severe headache vomiting, seizures; more subtle such as cognitive, emotional memory decline from compression adjacent tissue causing temporal lobe hypoplasia. Treatment is evacuation SDH, cystectomy communication between cyst cerebral cistern has also been proposed. We report a case 7 year old boy admitted bilateral arm paresthesia, setting possible prior neck trauma during trampoline play. He frequented Emergency Department twice preceding month new onset headaches, emesis pain. Physical examination was pain limited, non-focal. CT C spine did not show signs The following day, patient developed diplopia sent for MRI brain which showed large anterior fossa AC bleed significant mass effect herniation. taken urgent SDH drain placement. Post-operatively he rapidly improved back full baseline functionality. This highlights diagnostic difficulties intracystic hemorrhage, particularly unusual delayed presentation. It indicates need close follow among patients trauma. Disclosure: Dr. Naqvi nothing disclose. Katramados Agarwal