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Prevention of recurrence post leptomeningeal cyst repair

Abdulaziz O. Almubarak, Abdulkarim S. Al-Rabie, Rawan M. Alsolami and Mohammaed M. Homoud
Neurosciences Journal October 2018, 23 (4) 338-342; DOI: https://doi.org/10.17712/nsj.2018.4.20180242

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Frontal view of the patient showing typical Crouzon facies with swelling emerging from the vertex.

  • Figure 2
    Figure 2

    Timeline showing the chronological presentation, management and outcome of the patient.

  • Figure 3
    Figure 3

    Pre Operative CT brain without contrast: (A) scout image showed large extra-cranial swelling with features of bicoronal cynostosis. (B) Axial view showed tight brain with trigonocephaly. (C) upper cut with leptomeningial cyst (D&E) coronal & Sagital view showed large leptomeningeal cyst with brain herniation. (F&G) 3D images with signs of craniocynostosis and bone remodeling after the suturectomy.

  • Figure 4
    Figure 4

    Intraoperative picture of the second repair showing the recurrent cyst with dural substitute overlying the defect. The cyst recurred with adequate duroplasy.

  • Figure 5
    Figure 5

    Post operative imaging: (A) Scaut image showed fronto-orpital advancement with cranioplasty and Mish repair as well as disappear of extra-cranial collection. (B, C&D) Axial view showed brain relax after fronto-orbital advancement and trigonocephaly repair (E) Upper cut after leptomeningial cys resection and cranioplasty. (F) MRI brain with contrast showed duraplasty without signs of cyst collection.

  • Figure 6
    Figure 6

    Photo taken few months after discharge showing the cosmetic result of orbital bar advancement and the disappearance of the swelling without recurrence.

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