ISSN - 0973-0958

Pediatric Oncall Journal View Article

Huge Arachnoid Cyst Presented with Bilateral Sixth Cranial Nerve Palsy
Ana Torres Rebelo1, Ana Isabel Martins2, Sara Rodrigues1, Josue Pereira3, Sónia Aires1.
1Pediatrics department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria Da Feira, Portugal,
2Pediatrics department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,
3Pediatric Neurosurgeon, Department of Neurosurgery, Centro Hospitalar Universitário de São João CHUSJ e Faculdade de Medicina da Universidade do Porto FMUP, Porto, Portugal.
Abstract
Arachnoid cysts (AC), extra-axial cerebrospinal fluid (CSF) collections of variable brain and spine location, are generally asymptomatic and detected incidentally on imaging. When large, or during expanding processes, may cause neurological signs and symptoms, mainly by intracranial hypertension (ICH). Cranial nerve deficits are rare presenting manifestations associated with AC.
An 8-year-old boy was observed at the emergency department with 3 months history of headache and double vision. On physical examination, a sixth cranial nerve palsy was identified. Computed tomography scan and magnetic resonance imaging detected a large arachnoid cyst in the left middle, posterior, and anterior cranial fossa with brain compression and midline shift. Endoscopic fenestration of the arachnoid cyst to basal cisterns was performed with complete clinical recovery.

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