HİDROSEFALİYE YOL AÇAN DERMOİD KİST OLGUSU The Case of Dermoid Cyst Causing Hydrocephalus
İntrakranial dermoid kistler nadir görülen, selim, yavaş büyüyen ektodermal hücrelerin inklüzyonlarındanköken alan lezyonlardır. Genellikle asemptomatiktirler; semptomatik olduklarındarüptüre olurlar. Bu durumda kafaiçi basınç artışına, hidrosefaliye, aseptik menenjite veepilepsiye yol açabilirler.Uzun zamandır olan ancak son 2 aydır sabahları daha belirgin olmak üzere günün her saatindede devam eden sıkıştırıcı tarzda, bulantı-kusmanın ve otonom bulgularının eşlik etmediği,aura ve foto-fonofobinin olmadığı atipik baş ağrısı tarif eden 17 yaşında bayan hasta Nörolojipolikliniğine başvurdu. Yapılan nörolojik muayenede fundusta venöz dolgunluk dışında patolojisaptanmadı. Atipik baş ağrısı olan hastaya sekonder baş ağrısı nedeniyle beyin bilgisayarlıtomografisi çekildi ve dermoid kiste bağlı hidrosefali bulguları saptandı.Nadir olarak görülen ve görüldüğünde rüptürle sonuçlanan atipik baş ağrısıyla presente 17yaşındaki bayan hastayı sunmayı değer bulduk.Anahtar Sözcu¨kler: Dermoid Kist; Hidrosefali; Baş ağrısı; Frontal lobABSTRACTIntracranial dermoid cysts are rarely seen, benign and slowly growing lessions origining fromectodermal cells. Although they usually behave asymptomatic, often rupture is seen whenthey become sympthomatic resulting with an increase in intracranial pressure, hydrosephalus,aseptic menengitis and epilepsy.A 17 year old female applied to the neurology department with an atypical headache withouta photo-phonofobia and aura. The patient had suffered from this headache for a very longtime but for the last two months headache had become more evident all day long especiallyin the morning hours turning out to be more tensive during this period, and autonom findings,vomiting and nausea was not accompanying to headache. In the physical examination, nopathology were determined except venous distension in fundus. A cranial computerizedtomography was applied to the patient suffering from atypic headache due to the secondaryheadache causes, and a hydrocephalus resulting from a dermoid cyst was determied.We aimed to present a case of a dermoid cyst, which is rareley seen and have a high risk ofrupture when becoming symptomatic, causing an atypic headache in a 17 year old femalepatient.Keywords: Dermoid Cyst; Hydrocephalus; Headache; Frontal Lobe
___
- 1. Baxter JW, Netsky MG. (1985) Epidermoid and dermoid tumors
pathology. In: Wilkins RH, Renganchary SS, eds. Neurosurgery. (669-
688) New York: Mc Graw Hill.
2. Asil K, Gunduz Y, Ayhan LT, Aksoy YE, Yildiz C. Spontaneous
rupture of intracranial dermoid tumor in a patient with vertigo:
Computed tomography and magnetic resonance imaging findings.
Pol J Radiol. 2013;78(4):79-82.
3. Cllallg YH. (2010) Dermoid cyst. In: Diagnostic imaging brain. (7-
14) Salt Lake City, Utah: Amirsys.
4. Brown JY, Morokoff AP, Mitchell PJ, Gonzales MF. Unusual imaging
appearance of an intracranial dermoid cyst. Am J Neuroradiol
2001;22:1970–2.
5. McLendon RE. (1996) Epidermoid and dermoid tumors: pathology.
In: Wilkins RH, Rengachary SS, eds. Neurosurgery. (2nd ed.)
(959-963) New York: McGraw-Hill.
6. Katzman GL. (2004) Dermoid cyst. In: Diagnostic imaging: brain.
(7-12) Salt Lake City, Utah: Amirsys.
7. Orakcioglu B, Halatsch ME, Fortunati M, Unterberg A, Yonekawa
YB. Intracranial dermoid cysts: variations of radiological and clinical
features. Acta Neurochir. 2008;150(12):1227-34.
8. Guidetti B, Gagliardi FM. Epidermoid and dermoid cysts. Clinical
evaluation and late surgical results. J Neurosurg 1977;47:12-8.
9. Liu JK, Gottfried ON, Salzman KL, Schmidt RH, Couldwell WT. Ruptured
intracranial dermoid cysts: Clinical, radiographic and surgical
features. Neurosurgery 2008;62:377-84.
10. Wilms G, Casselman J, Ph. Demaerel, Plets C, Haene I, Baert
AL. CT and MRI of ruptured intracranial dermoids. Neurolradiology
1991;33:149-51