Dermal Sinus Traktusu İle İlişkili Enfekte Serebellar Dermoid Kist: Olgu Sunumu

Objective: Dermal sinus tracts are abnormal communications between the skin and deeper tissues. Congenital cranial dermal sinuses are midline tracts lined by stratified squamous epithelium that extend between the superficial dermal layer and deeper cranial structures. The tract may expand anywhere along its length to form dermoids or less commonly epidermoid cysts. In the cranial vault, the majority are located in the occipital region. Cerebellar abscess induced by a dermal sinus tract is a rare event. Although they are benign lesions, there is a high incidence of complications, especially infections such as bacterial or aseptic meningitis and cerebellar abscess. Clinical presentation: A six year-old patient of an occipital dermal sinus tract associated with infected dermoid cyst and a cerebellar abscess manifested with recurrent meningitis is presented. The dermal sinus tract was followed through the cerebellum and the infected dermoid cyst and abscess formation were removed completely. Conclusion: Dermal sinus tracts have a nonspecific clinical presentation such as recurrent meningitis, abscess formation, increased intracranial pressure and hydrocephalus. In addition to magnetic resonance imaging, the bony defect on bone-window computed tomography is diagnostic for the pathology. Magnetic resonance imaging may show soft tissue and tract itself as well as the associated dermoid cyst. CT scans (in bone windows) can demonstrate the tract traversing the bony skeleton. The most important information obtained from magnetic resonance imaging and CT studies is to access the extension of dermal sinus and particularly to determine whether or not the intracranial extension of the sinus or an intracranial cyst is present. The total surgical removal of the intracranial, extracranial components and cyst tract is important for prevention of recurrences.