Abstract
A 2-year-old female patient presented after experiencing a generalized tonic-clonic
seizure accompanied by fever, followed by a loss of consciousness. She underwent an
urgent right frontal external ventricular drain placement. Intraoperative cerebrospinal
fluid analysis was negative for infectious patterns. MRI showed a predominantly cystic
lesion in the midline posterior fossa, with a compressive mass effect. Subsequently,
she underwent a suboccipital craniotomy for microscopic resection of a posterior cranial
fossa lesion. Histopathology reported keratin flakes with severe active inflammation,
and foreign body type giant cell reaction in scalp excision with free hair shafts
through the inflammatory focus, consistent with pilonidal sinus. The patient was then
discharged home in good health.
Keywords
pilonidal sinus - cranial cystic lesion - posterior cranial fossa - pediatric neurosurgery
