Journal of Pediatric Neurology 2008; 06(01): 061-064 DOI: 10.1055/s-0035-1557415
Case Report
Georg Thieme Verlag KG Stuttgart – New York
Subdural hygroma associated with axillary cystic hygroma
Joseph Kaleyias
a
Department of Pediatrics, Division of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
,
Diana X. Bharucha
b
Medical Student, Drexel University College of Medicine, Philadelphia, PA, USA
,
William Yorns
c
Medical Student, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
,
Jill W. Miller-Horn
d
Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
,
Christine Finck
e
Department of Surgery, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
,
Joseph H. Piatt
f
Department of Neurosurgery, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
,
Sanjeev V. Kothare
a
Department of Pediatrics, Division of Neurology, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
We present a case of a 4-month-old girl with a history of a huge axillary cystic hygroma since birth, with elective surgical resection of the lesion and subsequent development of infection at the surgery site. During hospitalization for the infection, she developed seizures, a bulging fontanelle, increased head circumference, and widely separated cranial sutures. Brain imaging demonstrated new, large, bilateral subdural fluid collections with membrane enhancement around the left-sided collection. She was managed by subdural tap, bilateral craniotomy, broad-spectrum antibiotics, and subduroperitoneal shunt insertion. Ultimately, she had complete recovery without complications. This case adds to the spectrum of intracranial conditions that have been associated with cystic hygroma.
