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Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma

Arachnoid cysts are CSF-containing entities that rarely are symptomatic or warrant neurosurgical intervention. In addition, infection of these lesions is an even rarer event, with only four reports in the literature capturing this. In this report, we present the case of a 79-year-old man presenting...

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Autores principales: Christodoulides, Ioannis, Syrris, Christoforos, Lavrador, Jose Pedro, Chandler, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383888/
https://www.ncbi.nlm.nih.gov/pubmed/34426424
http://dx.doi.org/10.1136/bcr-2021-243405
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author Christodoulides, Ioannis
Syrris, Christoforos
Lavrador, Jose Pedro
Chandler, Christopher
author_facet Christodoulides, Ioannis
Syrris, Christoforos
Lavrador, Jose Pedro
Chandler, Christopher
author_sort Christodoulides, Ioannis
collection PubMed
description Arachnoid cysts are CSF-containing entities that rarely are symptomatic or warrant neurosurgical intervention. In addition, infection of these lesions is an even rarer event, with only four reports in the literature capturing this. In this report, we present the case of a 79-year-old man presenting with paraparesis, secondary to a right parasagittal meningioma, with an incidental asymptomatic right sylvian arachnoid cyst (Galassi type II). The initially planned surgery was postponed for 3 months, due to COVID-19 restrictions, and he was kept on high dose of steroids. Following tumour resection, the patient developed bilateral subdural empyemas with involvement of the arachnoid cyst, requiring bilateral craniotomies for evacuation of the empyemas and drainage of the arachnoid cyst. Suppuration of central nervous system arachnoid cysts is a very rare complication following cranial surgery with the main working hypotheses including direct inoculation from surrounding inflamed meninges or haematogenous spread secondary to systemic bacteraemia, potentiated by steroid-induced immunosuppression. Even though being a rarity, infection of arachnoid cysts should be considered in immunosuppressed patients in the presence of risk factors such as previous craniotomy.
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spelling pubmed-83838882021-09-09 Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma Christodoulides, Ioannis Syrris, Christoforos Lavrador, Jose Pedro Chandler, Christopher BMJ Case Rep Case Report Arachnoid cysts are CSF-containing entities that rarely are symptomatic or warrant neurosurgical intervention. In addition, infection of these lesions is an even rarer event, with only four reports in the literature capturing this. In this report, we present the case of a 79-year-old man presenting with paraparesis, secondary to a right parasagittal meningioma, with an incidental asymptomatic right sylvian arachnoid cyst (Galassi type II). The initially planned surgery was postponed for 3 months, due to COVID-19 restrictions, and he was kept on high dose of steroids. Following tumour resection, the patient developed bilateral subdural empyemas with involvement of the arachnoid cyst, requiring bilateral craniotomies for evacuation of the empyemas and drainage of the arachnoid cyst. Suppuration of central nervous system arachnoid cysts is a very rare complication following cranial surgery with the main working hypotheses including direct inoculation from surrounding inflamed meninges or haematogenous spread secondary to systemic bacteraemia, potentiated by steroid-induced immunosuppression. Even though being a rarity, infection of arachnoid cysts should be considered in immunosuppressed patients in the presence of risk factors such as previous craniotomy. BMJ Publishing Group 2021-08-23 /pmc/articles/PMC8383888/ /pubmed/34426424 http://dx.doi.org/10.1136/bcr-2021-243405 Text en © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. https://bmj.com/coronavirus/usageThis article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
spellingShingle Case Report
Christodoulides, Ioannis
Syrris, Christoforos
Lavrador, Jose Pedro
Chandler, Christopher
Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title_full Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title_fullStr Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title_full_unstemmed Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title_short Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma
title_sort infection of a sylvian galassi ii arachnoid cyst after craniotomy for resection of a parasagittal meningioma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383888/
https://www.ncbi.nlm.nih.gov/pubmed/34426424
http://dx.doi.org/10.1136/bcr-2021-243405
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