Intracranial dermoid cyst rupture-related brain ischemia: Case report and hemodynamic study

Vasospasm and subsequent stroke from paraneoplastic syndrome in a pediatric patient with an intracranial mature teratoma: a case report

Teratomas account for 18-20% of all intracranial germ cell tumors and mostly occur in the pineal region with only a few cases of pediatric sellar and suprasellar teratomas described in the literature. Here, we present a case of a child with an intracranial mature teratoma with pancreatic features causing vasospasm and subsequent stroke, found to be positive for CDKN2A-an independent variant associated with malignancy and small vessel disease leading to stroke.

Postoperative Symptomatic Cerebral Vasospasm: Requiring Attention Following an Uneventful Resection of an Epidermoid Cyst - A Case Report and Literature Review

Cerebral vasospasm associated with epidermoid cyst can be caused by tumor content spillage, such as spontaneous rupture and postsurgical resection. Symptomatic cerebral vasospasm following the resection of an intracranial epidermoid cyst is a rare but serious complication that lacks a consensus on treatment. Case presentation: A 10-year-old girl underwent an uneventful complete resection of a left cerebellopontine angle epidermoid cyst. On the second postoperative day (POD 2), she exhibited reduced speech, confusion, and hyperventilation followed by hypocapnia. On POD 4, she developed right hemiparesis and dysphasia. Cerebral magnetic resonance imaging showed restricted diffusion areas in her left temporal and parietal lobes and the dorsal thalamus. Magnetic resonance angiograms confirmed narrowing of the proximal middle cerebral arteries, consistent with vasospasm. Conservative management, consisting of intravenous hydration and corticosteroid administration, proved effective in resolving her symptoms and radiologic vasospasm. On POD 8, the extensive restricted diffusion areas notably decreased in size. Her right hemiparesis was completely resolved, and her dysphasia gradually improved over time. At the 1-year follow-up, she exhibited moderate transcortical sensory dysphasia. To our knowledge, this study is the first to report on a pediatric case of symptomatic cerebral vasospasm following an epidermoid cyst resection. The combination of tumor content spillage and hyperventilation may contribute to the occurrence of cerebral vasospasm and subsequent ischemia. This complication should be acknowledged after a complete and uneventful resection.

Late-onset rupture of an intracranial dermoid cyst: a case report

BACKGROUND

Dermoid cysts are developmental abnormalities occurring between the third and fifth week of embryogenesis. These lesions can initially develop as intracranial or extracranial and persist throughout the patient's lifetime. While generally benign, their symptoms can be due to mass effect or local irritation secondary to rupture and release of contents, typically presenting as headaches and seizures. Intracranial dermoid cysts are rare and comprise less than 1% of all intracranial lesions, with rupture occurring approximately 0.18% of the time.

CASE PRESENTATION

Our case describes a 42-year-old Hispanic female with a late-onset rupture of an intracranial dermoid cyst with associated new onset seizures. She underwent uncomplicated neurosurgical resection with mesh placement and was scheduled to follow-up as an outpatient.

CONCLUSION

To avoid rupture and associated sequelae in future patients, we recommend considering a more invasive approach as the initial strategy if internal cysts are relatively accessible.

Intracranial Epidermoid Cyst Mimics Musculoskeletal Shoulder Disease: Findings from a Case Report in Physiotherapy Clinical Practice

Shoulder pain is often attributable to a musculoskeletal disorder, but in some instances, it may be linked to pathologies outside the physiotherapist's area of expertise. Specifically, some intracranial problems can cause pain and disability to the shoulder complex. This case report aims to describe the clinical presentation, history taking, physical examination, and clinical decision-making procedures in a patient with an intracranial epidermoid cyst mimicking a musculoskeletal disorder of the shoulder girdle. A 42-year-old man complained of pain and disability in his left shoulder. Sudden, sharp pain was reported during overhead movements, associated with intermittent tingling of the left upper trapezius and left scapular area. Moreover, the patient reported reduced hearing in his left ear and left facial dysesthesia. The physical examination led the physiotherapist to hypothesize a pathology outside the physiotherapist's scope of practice and to refer the patient to another health professional to further investigate the patient through imaging. It is essential for the physiotherapist to recognize when the patient's clinical condition requires a referral to another healthcare professional. Therefore, the physiotherapist must be able to, in a timely manner, identify signs and symptoms suggesting the presence of medical pathology beyond his expertise, through appropriate medical history collection and physical evaluation.