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Acute respiratory failure as a manifestation of an arachnoid cyst

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Author(s): Pillai Lalitha | Achari Gopal | Desai Sanjay | Patil Vinayak

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 12;
Issue: 1;
Start page: 42;
Date: 2008;
Original page

Keywords: Cystoperitoneal shunt | posterior fossa arachnoid cyst | respiratory arrest

ABSTRACT
Arachnoid cysts are the most common congenital cystic lesions in the brain occurring in the middle fossa, suprasellar region and occasionally in the posterior fossa. Conventionally all cysts are considered as benign and symptoms are attributed to expansion of cysts causing compression of adjacent neurological structures, bleeds within the cyst or due to the development of acute hydrocephalus. We are reporting this case of a 15-year-old female patient with non-progressive weakness in the limbs since the age of seven years who presented with acute onset syncopal attacks and respiratory failure. She was intubated and ventilated. An magnetic resonance imaging scan showed large posterior fossa cyst extending up to mid second cervical vertebra causing compression of the medulla and pons, with mild hydrocephalus. After a failed attempt to wean her from the ventilator a cysto peritoneal shunt surgery was performed following which she was weaned from the ventilator successfully. Weakness in the upper and lower limbs, which had increased in the preceding month, also improved following the surgery.
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