PRESEPTAL SELÜLİT TANILI HASTADA ASEMPTOMATİK ARAKNOİD KİST: OLGU SUNUMU

Araknoid kistler, en yaygın intrakranial kistler olup intrakranial yer kaplayan lezyonların yaklaşık %1’ini oluşturur. 5 yaşında erkek hasta, 1 haftadır olan sağ gözde kaşıntı ve sağ göz etrafında şişlik yakınmalarıyla getirildi. Hastanın öyküsünden 2 ay önce düşerek sağ orbita lateralini taşa çarptığı, sonrasında aynı bölgede 1 hafta süren şişlik olup geçtiği öğrenildi. Fizik muayenesinde sağ göz kapağı ve gözün alt kısmında sirküler şekilde ödem tespit edildi. Göz hareketleri her yöne serbestti. Laboratuvar testlerinde, lökosit sayısı 9,817, hemoglobin 13.02 gr/dL, C-reaktif protein 0.328 mg/dL idi. Hastaya preseptal selülit tanısıyla intravenöz ampisilin sulbaktam (150 mg/kg/gün) tedavisi başlandı. Hastanın olası orbital malignite açısından orbital tomografisi çekildi. Sağ periorbital alanda cilt-cilt altı dokuda kalınlık artışı ve sağ temporal lobda araknoid kist ile uyumlu görünüm saptanması üzerine hastaya kontrastlı beyin manyetik rezonans görüntülemesi çekildi. Sağ temporal lob anterior kesimde yaklaşık 5x5 cm ebatlı, beyin omurilik sıvısı ile izointens görünüm (araknoid kist) saptandı. Beyin cerrahisi bölümünce acil cerrahi müdahaleye gerek görülmedi ve 6 ay aralıklarla Beyin Cerrahisi bölümüne kontrole gelmek üzere taburcu edildi. Araknoid kistler çocukluk çağında en sık tanı alan gelişimsel santral sinir sistemi anomalileridir. Asemptomatik olgular 6 ay-1 yıl aralıklarla klinik ve radyolojik olarak takip edilir.

ASYMPTOMATIC ARACHNOID CYST IN A PATIENT WITH PRESEPTAL CELLULITIS: A CASE REPORT

Arachnoid cysts are the most common intracranial cysts, accounting for approximately 1% of intracranial lesions. A 5 years old male patient was admitted with complaints of pruritus and swelling around the right eye for 1 week. It was learned that 2 months ago the patient hit the right lateral side of orbita and had a swelling for 1 week. On physical examination, edema was detected on the right eyelid and lower part of the eye. Eye movements were free in all directions. On laboratory, leukocyte was 9,817; hemoglobin was 13.02 gr/dL; and C-reactive protein was 0.328 mg/dL. Intravenous ampicillin sulbactam (150 mg/kg/day) treatment was initiated with the diagnosis of preseptal cellulitis. Orbital tomography was performed in case of possible orbital malignancy. Brain magnetic resonance imaging of the patient was performed because the right periorbital area was thicker in skinsubcutaneous tissue and the appearance in the right temporal lobe was compatible with arachnoid cyst.A lesion appearing isointense density (arachnoid cyst) with cerebrospinal fluid, in approximately 5x5 cm diameters, was detected in the anterior segment of the right temporal lobe. Neurosurgery department did not consider immediate surgical intervention. He was discharged with the plan of controls in neurosurgery department in 6 months intervals. Arachnoid cysts are the most common developmental central nervous system anomalies in childhood. Asymptomatic cases are followed clinically and radiologically with 6 months-1 year intervals.

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