A Report on Two Cases of Spontaneous Cutaneous Rupture Secondary to Severe Congenital Hydrocephalus
Van Euldem Battad; MD1*, Oliver Ryan Malilay; MD1, Kevin Paul Ferraris; MD1, Kenny Seng; MD1,2 Joseph Erroll Navarro; MD1
1Section of Neurosurgery, Department of Surgery, Jose R. Reyes Memorial Medical Center, Manila, Philippines.
2Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, Manila, Philippines.
*Corresponding Author: Van Euldem Battad; MD, Section of Neurosurgery, Department of Surgery, Jose R. Reyes Memorial Medical Center, Manila, Philippines.
https://doi.org/10.58624/SVOANE.2024.06.013
Received: November 12, 2024
Published: May 06, 2025
Citation: Battad VE, Malilay OR, Ferraris KP, Seng K, Navarro JE. A Report on Two Cases of Spontaneous Cutaneous Rupture Secondary to Severe Congenital Hydrocephalus. SVOA Neurology 2025, 6:3, 65-69. doi. 10.58624/SVOANE.2024.06.013
Abstract
Introduction: Congenital hydrocephalus is one of the most common causes of neurosurgical consults globally. Management delays may cause unique complications such as spontaneous cutaneous rupture and cerebrospinal fluid leakage. This may occur frequently in low-to-middle income countries, where prenatal and neurosurgical healthcare services are less accessible; however, no such cases have been recorded in the Philippines.
Case Presentation: We present two cases of severe hydrocephalus with spontaneous cutaneous rupture. The first is a 7- month-old female with leaking CSF from a 1-centimeter spontaneous cutaneous rupture at the right anterior aspect of her anterior fontanelle. On admission, her head circumference was 85 cm. Her imaging showed markedly dilated lateral ventricles with pneumoventricle, and a widened anterior fontanelle. Her defect was sutured, and she was treated with appropriate antibiotics. She was discharged once infection resolved, but eventually expired at home.
Discussion: The second is a 3-year-old male who presented with leaking CSF from a cutaneous rupture at the anterior border of the posterior fontanelle. His head circumference was 92cm, with a 4-centimeter scalp defect exposing the underlying ventricle. The defect was sutured at the emergency room. His family refused further diagnostics and treatment, and opted to bring him home, and was lost to follow-up.
Results: Only a few case reports on spontaneous cutaneous rupture are available to guide its treatment, with none coming from the Philippines. Our cases establish the local incidence of this underreported complication and demonstrate that simple suturing and antibiotic treatment do not lead to desirable outcomes.
Keywords: Hydrocephalus, Spontaneous Rupture, Philippines, Case Report
