Giant frontal and cerebellopontine angle epidermoid cyst

Abstract

We present the case of a 38-years old woman presenting in a state of unconsciousness, (Glasgow Coma Scale score 7), with right hemiparesis, the onset of symptoms being acute, after 3 consecutive convulsive crisis, in a patient with no previous neurological sign, except progressive aggravating headaches. Cranial computed tomography reveal an enormous hypodense lesion in the left frontal and temporal lobe, frontal horns of the ventricular system and prepontine and cerebellopontine angle regions. The patient underwent emergent surgical intervention, the evacuation of the content and partial removal of the capsule of the giant epidermoid cyst was achieved by frontal craniotomy. The diagnosis was presumed by the classical aspect of the content of the cyst and it was confirmed by histological examination. The immediate postoperative evolution was good with regression of hemiparesis and comatose state, with one complication in the third day after surgery; she developed the symptoms of Mollaret meningitis, with nearly normal CSF parameters, who responded well at the treatment with dexamethasone.

Keywords

• epidermoid cyst
• aseptic meningitis