A leptomeningeal cyst is a growing skull fracture. It can be caused by head trauma in young children or newborns, including accident injuries or head trauma during a difficult delivery. It may take some time before a skull fracture is identified and it may indicate further brain trauma in a newborn. In some cases, brain fractures and brain injury may be caused by negligent medical care during labor.
What is a Leptomeningeal Cyst?
A leptomeningeal cyst is a type of growing skull fracture. Also called a craniocerebral erosion, it is a complication of a skull fracture for children and infants. After a skull fracture in a young person with a still-growing skull, enlargement of the fracture line can cause a growth or bump in the skull. A leptomeningeal cyst is associated with a cystic mass filled with cerebrospinal fluid (CSF).
Growing skull fractures generally occur after head trauma in children during the first 3 years of life but primarily in infancy. When the skull is fractured, the brain growth may cause cerebral or subarachnoid herniation through the ruptured dura mater. This herniation may cause the fracture to grow, presenting as an extrusion or bump in the skull.
A leptomeningeal cyst may also represent further brain damage caused by the underlying head trauma. If head trauma is severe enough to cause a rupture in the skull and dura it may also cause additional brain damage. Underlying brain damage is commonly associated with leptomeningeal cysts, although not necessarily.
Leptomeningeal Cyst is Not a Cyst
A leptomeningeal cyst is not really a cyst. A cyst is a pocket of tissue that may contain air, fluid, pus, or other materials. Cysts can be benign and clear up on their own but other types of cysts may be cancerous or precancerous and need to be evaluated by a doctor. In contrast, a leptomeningeal “cyst” is the mass caused by the skull fracture in a still-growing skull.
Causes of Growing Skull Fractures
A skull fracture can be caused by traumatic injury to the skull. In children up to 3 years old or older, their skulls are still growing and a fracture from a fall, car accident, or violent injury could cause a mass to develop at the site of the injury. If parents are not aware of an injury but notice a skull mass, they should consult a doctor to determine if there are further injuries and seek treatment.
In infants, leptomeningeal cysts may be caused by birth complications. Delivery complications can make it more difficult for vaginal delivery. In some cases, a cesarean section delivery may be better than vaginal delivery to reduce the risk of injury to the baby and mother. Some common causes of delivery complications include:
- Babies that weigh over 8 pounds 13 ounces (macrosomia)
- Baby’s head or body is too large to fit through the mother’s pelvis (cephalopelvic disproportion)
- Abnormal position and presentation (breech, face-first, or shoulder presentation)
- Babies born premature (before 37th week of pregnancy)
- Difficult childbirth (dystocia)
Other Traumatic Head Injuries During Labor
A leptomeningeal cyst is only one type of head injury that can occur during labor. As a result of a growing skull fracture, children can present with an enlarging scalp mass. This may be the sole injury or it may indicate further damage beyond view within the brain.
Many head and brain injuries during labor are caused by bleeding inside the skull. Bleeding in the skull, or a hemorrhage, can be caused by using too much force on the head during delivery, improper delivery techniques, or the use of assisted devices like a vacuum extractor or forceps. Bleeding in the head can include:
- Cerebral hemorrhage
- Intracranial hemorrhage
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage
- Intraventricular hemorrhage
Diagnosis of Leptomeningeal Cyst Skull Injuries in Babies
The initial signs of a leptomeningeal cyst may include a mass in the skull, a bump, or growth in the head. There may be other signs of skull injury or head injury, including:
- Speech problems
- Developmental delays
- Vision problems
- Other focal neurological deficit
Treatment for Leptomeningeal Cysts in Newborns
Treatment for a leptomeningeal cyst may include surgery. Surgical treatment can remove the lesion and close up the dura. This can prevent further damage to the brain. Without treatment, there may be progressive erosion of the skull around the site of the fracture. Without treatment, the leptomeningeal cyst may lead to seizures, mental retardation, intracranial pressure, or other brain damage.
Medical Malpractice and Newborn Head Injuries
Labor can be a very difficult time for parents, especially for first-time parents who are unfamiliar with the birthing process. Labor may come on suddenly and delivery can happen within a matter of moments. Labor may also have to be induced or take hours before the child is delivered. During a difficult labor, the parents may feel a sense of powerlessness at the hands of the medical establishment.
A doctor or OB/GYN may make decisions without careful consultation with the parents. In some cases, the doctor’s decisions may be the wrong ones, putting the child and mother at risk of serious harm. During a difficult delivery, the doctor may be in a hurry and resort to using assistive devices like a vacuum extractor to try and suck the baby out by the head. Forceps may also be used which can increase the risk of damage to the skull.
The parents may not even know about a birth injury until long after they leave the hospital. Some injuries like leptomeningeal cysts take time to develop and the parents may not see signs of the skull fracture until days or weeks later. In brain injuries without outward signs, the parents may not learn about brain damage until their child shows developmental delays, years after the damage was done.
Birth Injury Medical Malpractice Lawyers
If your child was injured because of medical negligence in a Philadelphia hospital, talk to an experienced birth injury attorney about your options for recovery. Doctors and hospitals should be held accountable for their actions to help other families avoid similar harm. Do not hesitate to contact Gilman & Bedigian today for a free consultation.