양성 송과선 낭종이 동반된 Mollaret 수막염 1례

A Case of Mollaret’s Meningitis Associated with Benign Pineal Cyst.

저자들은 두통, 구토, 발열 등을 주소로 하여 4개월 동안 3회의 재발성 무균성 수막염으로 입원한 3세 남아에서 뇌척수액의 세포학적 검사상 다형핵 백혈구 우위의 세포증가증과 함께 상피세포군이 발견되었고 뇌 자기공명영상을 통해 양성 송과선 낭종이 확인됨으로써 이 양성 송과선 낭종의 자연적인 파열로 인해 유발된 것으로 추정된느 Mollaret 수막엽 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Mollaret’s meningitis is a recurrent aseptic meningitis with characteristic clinical features and Mollaret cells in cerebrospinal fluid(CSF). We describe a case of Mollaret’s meningitis in a 3-year-old boy who presented with three episodes of aseptic meningitis within a 4-month period. Each episode was characterized by sudden onset of meningeal irritation followed by spontaneous remission in several days. He was free of neurological symptoms between the episodes. In the acute phase of each episode, his CSF showed polymorphonuclear pleocytosis with normal protein and glucose concentrations. In addition, some epithelial cell clusters in the CSF were evident during the third episode. No pathogenic microorganisms were identified in the CSF or the blood cultures. Brain MRI revealed a benign pineal cyst, 0.8 cm in diameter, and epithelial cell clusters were supposed to represent ruptured cystic walls and recurrent episodes of aseptic meningitis were triggered by spontaneous rupture of the cyst. Our case appears to support "spontaneous rupture of epidermoid cysts in the central nervous system" as one of the etiologies of Mollaret’s meningitis.