Chemical meningitis from a leaking craniopharyngioma: a case report

Abstract

Recurrent chemical meningitis from cyclic leakage of cyst content from a craniopharyngioma is a rare phenomenon. Here, we report a case of leaking cystic craniopharyngioma presenting with recurrent episodes of sterile meningitis, depression, and paranoia. The diagnosis after an initial craniotomy and exploration was hypophysitis. Signs and symptoms were not alleviated by puncture and biopsy of the tumour but they disappeared after complete resection with a final histological diagnosis of craniopharyngioma.

Aseptic Meningitis Due to Spontaneous Rupture of a Multicystic Craniopharyngioma with an Ommaya Catheter: A Case Report

“…Aseptic meningitis due to rupture of an intracranial tumor is a relatively well-known event, 34 but the spontaneous rupture of CPs causing aseptic meningitis is even more rare with 20 reported patients in the English literature ( Supplementary Table S1 [online only]). 5 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 Such clinical scenario comprises the most frequent clinical presentation of spontaneous CP rupture, which also includes improvement of neurological deficits, 11 27 30 asymptomatic rupture documented on follow-up imaging, 25 31 and vasospasm. 29 There is a considerable increase in spontaneous CP rupture diagnosis after the 1980s, which is associated with the advent of CT and MRI.…”

“… 8 To date, less than 35 cases of spontaneous CP rupture have been reported in the English literature. 5 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Herein, we present a report of an adolescent with a multicystic CP who experienced an episode of aseptic meningitis due to spontaneous rupture of the ventricular cyst, which contained an Ommaya catheter.…”

Intracranial neurenteric cyst with post-operative chemical meningitis and vagal nerve palsy

“…The mechanism of action is believed to be secondary to the leakage of cyst contents into the subarachnoid space [2] . To date, several cases of chemical meningitis as a result of leakage of intracranial cystic contents have been described in the literature, including a recurrent case of chemical meningitis caused by a leaking craniopharyngioma [13] and a few cases related to ruptured epidermoid cysts [14 , 15] and ruptured dermoid cyst [16] . Since the occurrence of neurenteric cysts is exceedingly rare in comparison to the other intracranial lesions, cases of chemical meningitis in association with neurenteric cysts are quite uncommon.…”

Adipsic diabetes insipidus secondary to craniopharyngioma resection

“…During the fever episode, the cultures were negative, so the diagnosis of aseptic meningitis was made, with the limitation of not having carried out studies for viral aetiologies. Cases of chemical meningitis have been reported due to rupture of the cystic content of the craniopharyngioma30 31; however, they usually occur prior to the procedure. In our case, there was no reported rupture of the contents during the resection, nor did the patient present a cystic lesion after the procedure since the resection was complete, so the probability that the episode of meningitis is associated with the craniopharyngioma content is low.…”