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Case Reports
. 2017 Jul-Sep;12(3):280-284.
doi: 10.4103/jpn.JPN_34_17.

Perinatal Rapid Enlargement of Suprasellar-Prepontine Arachnoid Cyst: Report of Case and Literature Review

Sachin Baldawa  1 , Sampat Baldawa  2 , Pratibha Baldawa  2 , Rakhi Sarda  2 , Sunil Hogade  3
Affiliations
Case Reports

Perinatal Rapid Enlargement of Suprasellar-Prepontine Arachnoid Cyst: Report of Case and Literature Review

Sachin Baldawa et al. J Pediatr Neurosci. 2017 Jul-Sep.

Abstract

Arachnoid cysts are benign developmental anomalies representing 1% of all intracranial lesions. Suprasellar prepontine location of arachnoid cyst in the perinatal period has been reported in the perinatal period with the advent of prenatal imaging. A rare case of rapidly enlarging suprasellar prepontine arachnoid cyst diagnosed at 28 weeks on routine antenatal ultrasonographic and magnetic resonance imaging is presented. Rapid enlargement of the cyst near term led to endoscopic fenestration of the cyst and ventriculocystocisternostomy followed by ventriculoperitoneal shunt in the postnatal life. Serial imaging in the perinatal period led to early intervention with good postnatal outcome. We also review all cases of prenatal suprasellar prepontine arachnoid cyst mentioned in literature and discuss the management strategies.

Keywords: Prenatal diagnosis; rapid enlargement; sonographic examination; suprasellar arachnoid cyst.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Axial T2-weighted (a) and sagittal T2-weighted magnetic resonance imaging (b) done at 29 weeks gestational age revealed a cyst in the suprasellar-prepontine region measuring 1.8 cm × 1.7 cm × 1.5 cm. (a) The lateral ventricles were mildly dilated. There was no occlusion of the foramen of Monro (a) or aqueduct of sylvius (b)
Figure 2
Figure 2
Magnetic resonance imaging of the brain performed on day 1 postnatally revealed a suprasellar prepontine cyst measuring 5.8 cm × 5.6 cm × 5.1 cm. The signal intensities of cyst fluid-matched signal intensities of cerebrospinal fluid on all sequences. (a, b and c) The cyst was displacing the floor of the third ventricle upward occluding the foramen of Monro. (a, b and d) The brainstem was stretched and displaced posteriorly occluding the aqueduct of sylvius resulting in obstructive hydrocephalus
Figure 3
Figure 3
(a) Computed tomography of the brain revealed persistent hydrocephalus. (b) Ventriculoperitoneal shunt was placed through the right frontal burr hole
See this image and copyright information in PMC

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