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Virtual Pediatric Hospital: Paediapaedia: Leptomeningeal Cyst Paediapaedia: Neurological Diseases

Leptomeningeal Cyst

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
A palpable, soft, fluctuant pulsatile mass that gradually increases in size at the site of an old skull fracture. It is rare an occurs predominantly in children less than 3 years old.

Etiology/Pathophysiology:
A chronic sequelae of an acute skull fracture which is complicated by an underlying dural tear. There is leakage of CSF from the underlying pia-arachnoid with protrusion of leptomeninges through the dural defect followed which is followed by formation of an encapsulated cyst. Continuous pulsatile CSF pressure causes the cyst to expand causing progressive erosion of the cranial vault. The enlarging cyst can also compress the underlying brain and cerebral cortex can herniate through the bony defect.

Pathology:
Not applicable

Imaging Findings:
Plain film showa a wide skull defect with smooth sclerotic edges at the site of a previous fracture.

A CT exam can be used to assess for underlying cerebral anomalies.

DDX:

References:
See References Chapter.

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