Infection of a sylvian Galassi II arachnoid cyst after craniotomy for resection of a parasagittal meningioma.
BMJ Case Rep
; 14(8)2021 Aug 23.
Article
in English
| MEDLINE | ID: covidwho-1370892
ABSTRACT
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.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Arachnoid Cysts
/
Craniotomy
/
Meningeal Neoplasms
/
Meningioma
Type of study:
Case report
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Bcr-2021-243405
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