Growing traumatic leptomeningeal cyst of the roof of the orbit presenting with unilateral exophthalmos

Abbass Amirjamshidi*, Kazem Abbassioun, Ali Sadeghi Tary, Tadanori Tomita

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND: Growing skull fractures rarely develop in the skull base region. To the best of our knowledge, only two similar cases have been reported in the English literature. This rare complication, which can occur even after a mild head injury, can produce exophthalmos and threaten the vision. METHODS: The clinical and radiological findings of expanding leptomeningeal cysts extending into the orbit in nine patients referred to the department of Neurosurgery are presented. After appropriate investigations confirming the presence of the expansile retroglobal lesion, surgical exploration was performed via fronto-lateral or the preferred fronto-basal approach. The variable findings are denoted and the relevant literature is also reviewed. RESULTS: Frontobasal head injuries play an important role in pathogenesis of these traumatic expansile leptomeningeal cysts. In this series of nine young girls, 6.65% (six out of nine) injuries happened in the first decade of life with an interval of 2 to 12 months (mean = 6.7, SD = 9.7). High-resolution coronal view computed tomography (CT) scanning with bone density window images, and high intensity cystic lesions visible on T2-weighted coronal MR images were diagnostic clues. CONCLUSIONS: Growing fractures of the anterior skull base may complicate the natural course of healing of any minor frontobasal head injury, especially during childhood. Good quality imaging is mandatory in cases of progressive unilateral exophthalmos. Proper surgical intervention will lead to a good cosmetic result. (C) 2000 by Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)178-182
Number of pages5
JournalSurgical Neurology
Volume54
Issue number2
DOIs
StatePublished - Nov 23 2000

Keywords

  • Growing skull fracture
  • Head trauma
  • Leptomeningeal cyst
  • Orbit
  • Skull base region
  • Unilateral exophthalmos

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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