J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e279-e283
DOI: 10.1055/s-0033-1349335
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Congenital Anomalies at the Craniovertebral Junction–Posterior Fossa Region: Report of Two Cases

Venkatesh S. Madhugiri
1   Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
,
Indira Devi Bhagavatula
2   Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
› Author Affiliations
Further Information

Publication History

02 October 2012

05 April 2013

Publication Date:
19 August 2013 (online)

Abstract

Background Various combinations of bony and soft tissue anomalies have been described at the craniovertebral junction (CVJ). These include posterior fossa dermoids (with or without dermal sinuses) associated with Klippel-Feil anomalies and dermoids (no previous reports of overlying dermal sinuses) associated with bony anomalies.

Patients Two patients with a combination of CVJ anomalies are described.

Results Both patients had a posterior fossa dermoid, dermal sinus, and occipitalized C1 arch. Furthermore, one patient had a complex bony CVJ anomaly, and the other had a Klippel-Feil anomaly in addition. The clinical presentation and management are elucidated.

Conclusions Patients who present with any one of these lesions need to be evaluated for the existence of other congenital anomalies. These are complex malformations to treat.

 
  • References

  • 1 Kennedy PT, McAuley DJ. Association of posterior fossa dermoid cyst and Klippel-Feil syndrome. AJNR Am J Neuroradiol 1998; 19 (1) 195-196 , discussion 196
  • 2 González-Darder JM, Feliu-Tatay R, Pesudo-Martínez JV, Vera-Román JM. Klippel-Feil syndrome associated with posterior fossa dermoid cyst. Case report. Neurol Res 2002; 24 (5) 501-504
  • 3 Tampieri D, Melanson D, Ethier R. MR imaging of epidermoid cysts. AJNR Am J Neuroradiol 1989; 10 (2) 351-356
  • 4 Chandra PS, Gupta A, Mishra NK, Mehta VS. Association of craniovertebral and upper cervical anomalies with dermoid and epidermoid cysts: report of four cases. Neurosurgery 2005; 56 (5) E1155
  • 5 Rubin G, Scienza R, Pasqualin A, Rosta L, Da Pian R. Craniocerebral epidermoids and dermoids. A review of 44 cases. Acta Neurochir (Wien) 1989; 97 (1-2) 1-16
  • 6 Wright RL. Congenital dermal sinuses. Prog Neurol Surg 1971; 4: 175-191
  • 7 Brydon HL. Intracranial dermoid cysts with nasal dermal sinuses. Acta Neurochir (Wien) 1992; 118 (3-4) 185-188
  • 8 Love JG, Kernohan JW. Dermoid and epidermoid tumors (cholesteatomas) of central nervous system. J Am Med Assoc 1936; 107: 1876-1883
  • 9 Sharma MS, Sharma BS, Yadav A, Khosla VK. Posterior fossa dermoid in association with Klippel-Feil syndrome—a short report. Neurol India 2001; 49 (2) 210-212
  • 10 Ramzan A, Khursheed N, Rumana M, Abrar W, Ashish J. Posterior fossa dermoid with Klippel-Feil syndrome in a child. Pediatr Neurol 2011; 45 (3) 197-199
  • 11 Muzumdar D, Goel A. Posterior cranial fossa dermoid in association with craniovertebral and cervical spinal anomaly: report of two cases. Pediatr Neurosurg 2001; 35 (3) 158-161
  • 12 Douvoyiannis M, Goldman DL, Abbott III IR, Litman N. Posterior fossa dermoid cyst with sinus tract and meningitis in a toddler. Pediatr Neurol 2008; 39 (1) 63-66
  • 13 Layadi F, Louhab N, Lmejjati M, Aniba K, Aït Elqadi A, Aït Benali S. Cerebellar dermoid cyst with occipital dermal sinus. Report of two pediatric cases. Pediatr Neurosurg 2006; 42 (6) 387-390
  • 14 Logue V, Till K. Posterior fossa dermoid cysts with special reference to intracranial infection. J Neurol Neurosurg Psychiatry 1952; 15 (1) 1-12
  • 15 Roberts AP. A case of intracranial dermoid cyst associated with the Klippel-Feil deformity and recurrent meningitis. Arch Dis Child 1958; 33 (169) 222-225
  • 16 Cai CQ, Zhang QJ, Hu XL, Wang CX. Dermoid cyst of the posterior fossa associated with congenital dermal sinus in a child. World J Pediatr 2008; 4 (1) 66-69
  • 17 Yang B, Jin HM, Sun LP, Cai W, Shi CR. Posterior fossa abscesses secondary to dermal sinus associated with dermoid cyst in children. Neuropediatrics 2008; 39 (1) 39-42
  • 18 Goel A. C1-2 fixation. J Neurosurg Spine 2008; 9 (2) 233-235 , author reply 235