DR. RAKENDU PUTHIYEDATH

DR.BEENA, DR. AMITHA SUNNY, DR. ANTHRAYOS C.V. KAKKANATT

Abstract

A 11 year old female child presented with headache and backpain for 1 month and double vision for 2weeks.On examination,vision was 6/6 in both eyes. Bilateral lateral rectus weakness 2+ was present.Pupils showed sluggish reaction.Fundus showed papilledema in both eyes.OCT ONH showed severe bilateral disc edema.Plain MRI brain showed intradiploic epidermoid cyst in occipital area with minimal mass effect.Lumbar puncture was done and CSF pressure recorded as 38mmHg.Patient was started on medical treatment(systemic steroids).Lumbo peritoneal shunt was adviced if CSF pressure remained high despite medical management. Patient was symptomatically better on subsequent visits.OCT ONH was repeated and showed resolution of disc edema.Fundus showed hyperaemic disc with clear margins.Intradiploic epidermoid cyst are commonly located in occipital,frontal and parietal bones.It is most commonly asymptomatic but if large in size,it may produce signs of raised intracranial pressure.