EROSION of the cranial bones from pressure of a leptomeningeal cyst is an uncommon, but not rare, condition. While the majority of such cysts develop after severe trauma to the skull, usually with fracture, there is evidence that congenital abnormalities in the dura and leptomeninges may contribute to their production. Haymaker and Foster1 reported a case in which a large collection of clear, colorless fluid resembling cerebrospinal fluid was found enclosed between the two layers of the dura in the posterior cranial fossa; a small defect was present beneath the tentorium, through which a lobule of the cerebellum was herniated. While their patient gave a history of a fracture of the skull in childhood, the separation of the dural layers and the small subtentorial defect may have been congenital abnormalities which favored development of a cyst in this location.Leptomeningeal cysts have been noted more commonly in the parietal, frontal and occipital regions. In the case to be described a difficult diagnostic and therapeutic problem was presented by the presence of an extensive area of destruction of bone in the floor of the middle cranial fossa.
REPORT OF CASEA 28 year old soldier was admitted to an Army general hospital with swelling about the right orbit and temporozygomatic region and with exophthalmos on the same side. One and one-half years before, in North Africa, the patient had received a mild cerebral concussion as a result of an explosion of several large bombs. The following morning he noticed swelling of the right temple and slight exophthalmos. These symptoms persisted for several days and then disappeared, but he continued to have occasional dull, aching pains in the right orbital region, which were relieved by analgesics. One year later he had pneumonia and was hospitalized. It was then noted that there were slight swelling of the temple and slight exophthalmos on the right side, with slight constriction of the right pupil. No other abnormal physical or neurologic signs were present. Roentgenographic examination of the skull revealed a group of cystic-appearing shadows in the right anterior temporal region and in the superior, posterior and lateral 1.
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