1
|
Talahma I, Abuzneid YS, Ismail A, Alqam L, Mufreh A, Shama'a BA. Encephalocele as a complication post-craniosynostosis surgery. J Surg Case Rep 2024; 2024:rjae442. [PMID: 38993814 PMCID: PMC11238248 DOI: 10.1093/jscr/rjae442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/23/2024] [Indexed: 07/13/2024] Open
Abstract
Duraplasty is one of the most common neurosurgical procedures which complications include iatrogenic pseudomeningocele, which is common, but ossification of pseudomeningocele following cranial surgery is a rare event. We present a case of a 2-year-old male patient who came to our hospital with a huge bulge in his head and weakness in the right arm and leg. He had a history of sagittal craniosynostosis with a postoperative cranioplasty complication of left parital pseudomeningocele. He underwent a duraplasty, but the bulge recurred with failed cerebrospinal fluid aspiration and external ventricular drain, changing in size periodically. Computed tomography showed that the bulge was a median and left paramedian parital encephalocele, so encephalocele with ossification was diagnosed and a cranioplasty was done. This case highlights that iatrogenic encephaloceles with ossification can develop after duraplasty repair in the parital region. Also, if a postoperative pseudomeningocele changes in size or consistency, clinicians should look for ossification.
Collapse
Affiliation(s)
- Imad Talahma
- Neurosurgery Department, Neuro-Spine Center, Palestine Red Crescent Society Hospital, Hebron, State of Palestine
- Neurosurgery Department, Palestine Polytechnic University Faculty of Medicine, Hebron, State of Palestine
| | - Yousef S Abuzneid
- Neurosurgery Department, Neuro-Spine Center, Palestine Red Crescent Society Hospital, Hebron, State of Palestine
| | - Ameer Ismail
- Palestine Polytechnic University Faculty of Medicine, Hebron, State of Palestine
| | - Lina Alqam
- Palestine Polytechnic University Faculty of Medicine, Hebron, State of Palestine
| | - Amaal Mufreh
- Palestine Polytechnic University Faculty of Medicine, Hebron, State of Palestine
| | - Bara Abu Shama'a
- Palestine Polytechnic University Faculty of Medicine, Hebron, State of Palestine
| |
Collapse
|
2
|
Alsallom F, Alzahrany M, Gonzalez-Martinez J, Jehi L. Epilepsy Surgery Outcome of Traumatic Intradiploic Meningoencephalocele: A Case Report and Literature Review. Clin EEG Neurosci 2024; 55:241-247. [PMID: 36520585 DOI: 10.1177/15500594221144420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We highlight an under-recognized epileptic pathology in a 56-year-old left-handed female with progressive right facial numbness and weekly focal seizures characterized by episodic aphasia. She was found to have a left frontoparietal intradiploic meningoencephalocele (IDME). Her only epilepsy risk factor was minor head trauma 10 years prior to presentation. She underwent craniotomy for encephalocele resection and mesh cranioplasty without residual neurological deficits and excellent seizure outcome: at 3-year follow-up, she was still seizure-free since surgery, except for an isolated breakthrough seizure at 7 postoperative months when she discontinued her preoperative regimen of Lacosamide monotherapy. Traumatic IDME is a rare condition and rarely presents with seizures. Symptoms may arise up to decades following minor head trauma and are progressive in nature. The likely definitive treatment is cranioplasty and dural repair with or without resecting the protruding parenchyma.
Collapse
Affiliation(s)
- Faisal Alsallom
- National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Majed Alzahrany
- Epilepsy Center, Neurological Institute Cleveland Clinic, Cleveland, OH, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jorge Gonzalez-Martinez
- Neurosurgery and Epilepsy Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Lara Jehi
- Epilepsy Center, Neurological Institute Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
3
|
Atli B, Rath S, Burtscher J, Hainfellner JA, Hametner S. Frontal intradiploic encephalocele in a 44-year-old male patient: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 4:CASE2270. [PMID: 36088567 PMCID: PMC9706332 DOI: 10.3171/case2270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Encephaloceles are protrusions of the cerebral tissue through a skull defect. They occur mostly in children and very rarely in adults. OBSERVATIONS The authors present a case of a 44-year-old man presenting with a first-time generalized seizure. Computed tomography of the head showed bone destruction associated with a right frontal lesion. Magnetic resonance imaging scans demonstrated a largely isointense lesion in the intradiploic space that contained small, hyperintense nodular components and showed a low to moderate contrast agent enhancement. LESSONS The patient underwent resection, during which the histological examination found the lesion to be an intradiploic encephalocele. The patient had an uneventful postoperative course with a cessation of seizures. The imaging and neuropathological findings as well as a literature review, together with a discussion on the etiology of intradiploic encephaloceles, are contained in this report.
Collapse
Affiliation(s)
- Baran Atli
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria; and
| | - Sebastian Rath
- Department of Neurosurgery, Wiener Neustadt State Hospital, Wiener Neustadt, Austria
| | - Johannes Burtscher
- Department of Neurosurgery, Wiener Neustadt State Hospital, Wiener Neustadt, Austria
| | - Johannes A. Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria; and
| | - Simon Hametner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria; and
| |
Collapse
|
4
|
Jeong DJ, Lee B, Yang K. Intradiploic Encephalocele at the Parietal Bone: A Case Report and Literature Review. Brain Tumor Res Treat 2022; 10:38-42. [PMID: 35118847 PMCID: PMC8819461 DOI: 10.14791/btrt.2022.10.e20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/01/2021] [Accepted: 10/08/2021] [Indexed: 11/20/2022] Open
Abstract
Intradiploic encephalocele is a rare condition of herniation of the brain parenchyma through the diploic space. A 52-year-old man presented with a parietal intradiploic encephalocele manifesting as an intermittent headache for 7 months. CT revealed an osteolytic lesion involving the right parietal bone. MRI demonstrated brain herniation within the diploic space. Surgery may be unnecessary in the absence of concurrent symptoms or neurological deficits. After 2 years of follow-up, symptoms were improved without neurological deficits and CT findings. We report the X-ray, CT, and MRI findings of an extremely rare case of parietal intradiploic encephalocele in adulthood.
Collapse
Affiliation(s)
- Dong Jun Jeong
- Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Boeun Lee
- Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Kookhee Yang
- Department of Neurosurgery, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| |
Collapse
|
5
|
Xu G, Liu S, Li X, Quan X, Deng H, Liu L, Zheng X, Li X, Liu L. A case of meningoencephalocele in the nasal cavity 6 years after skull base fracture. Neurol Sci 2021; 42:5379-5384. [PMID: 34557967 DOI: 10.1007/s10072-021-05604-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Guanghui Xu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Shengjie Liu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xin Li
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xingyun Quan
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Huajiang Deng
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Luotong Liu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xiaomei Zheng
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xianglong Li
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Liang Liu
- Department of Neurosurgery, Affiliated Hospital of Southwest Medical University, Xianglin Road, Luzhou, 646000, Sichuan, China. .,Sichuan Clinical Research Center for Neurosurgery, Luzhou, Sichuan, China. .,Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China. .,Neurological Diseases and Brain Function Laboratory, Luzhou, Sichuan, China.
| |
Collapse
|
6
|
Abstract
To evaluate the feasibility, safety, and accuracy of the new man-machine interactive robotic system in model experiment. The implantation of the 8 to 10 bone screws over the skull model obtained from real patient's digital imaging and communications in medicine (DICOM), three-dimensional spiral computed tomography (CT) scans were taken. The end of the robotic arm was replaced with standard parts (including marker ball) for cone beam computed tomography (CBCT) scanning. The marker ball and marker pin were segmented and marked and exported via txt format. The position of the robotic end and model was obtained through the conversion of spacious position of standard parts and the executive end was replaced eventually. The water balloon was placed inside the skull model to imitate the dura mater and the destruction was documented for the system's safety. The system accuracy was evaluated by the error between the actual drilling position and the virtual plan and selection of 14 points of the skull window of milling pathway, monitored intraoperatively via Micron Tracker system and the overall skull window overlapped percentage via Mimics. Five model experiments were successfully performed with the average registration time of 3 minutes without destruction of balloon. The error of the outer table was 0.85 ± 0.45 mm, the inner table was 0.78 ± 0.49 mm, the line segment error of milling cutter was 0.93 ± 0.50 mm and the overall skull window overlapped percentage was 97.37% ± 0.78%. The system shows safety, accuracy, and reliability which can be an optional assistant method for craniotomy in the future.
Collapse
|
7
|
Shi C, Flores B, Fisher S, Barnett SL. Symptomatic Parietal Intradiploic Encephalocele-A Case Report and Literature Review. J Neurol Surg Rep 2017; 78:e43-e48. [PMID: 28316901 PMCID: PMC5355005 DOI: 10.1055/s-0037-1599799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Encephalocele is a rare condition that consists of herniation of cerebral matter through openings of dura and skull. A majority of encephaloceles are congenital and manifest in childhood. We present a case of a 45-year-old man presenting with contralateral hemiparesis and found to have an extremely rare phenomenon of a symptomatic posttraumatic parietal intradiploic encephalocele (IE) manifesting 36 years following pediatric traumatic head injury. Computed tomography and magnetic resonance imaging confirmed herniation of brain tissue into the intradiploic space. Surgical treatment with reduction of the encephalocele achieved near resolution of preoperative hemiparesis on follow-up. The pathogenesis and a literature review of IE are discussed.
Collapse
Affiliation(s)
- Chen Shi
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Bruno Flores
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stephen Fisher
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Samuel L Barnett
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| |
Collapse
|
8
|
Giordano M, Di Rocco C. Iatrogenic intradiploic cerebrospinal fluid collection. Childs Nerv Syst 2016; 32:787-90. [PMID: 26869055 DOI: 10.1007/s00381-016-3037-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/03/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cases of intradiploic cerebrospinal fluid (CSF) collections have been previously reported in the literature with various underlying causes. We focus specifically on the iatrogenic cases of this rare but possible neurosurgical complication discussing the possible pathophysiological mechanisms and management strategy. CASE DESCRIPTION A 14-year-old boy was admitted in our institute with recurrent headache and worsening attention deficits. He was previously treated twice for a Chiari malformation type I. The performed imaging showed the persisting lower position of the cerebellar tonsils with a syrinx within the cervical spinal cord and a fluid collection within the occipital bone with thinning of outer and inner table. Occipital bone decompression with resection of the intradiploic cavity and enlarging duraplasty was performed. Postoperative imaging confirmed the removal of the iatrogenic-induced focal bone alteration. DISCUSSION AND CONCLUSION Iatrogenic intradiploic focal fluid accumulation can occur when a dural defect combines with an inner table defect of the calvaria or vertebral bones. Though rare, such a complication should be taken into account when postoperative imaging suggests a focal fluid collection inside the theca. The surgical excision of the lesion is mandatory due to the natural history of progression.
Collapse
Affiliation(s)
- Mario Giordano
- Department of neurosurgery, International Neuroscience Institute, Rudolf Pichlmayr Str. 4, 30625, Hannover, Germany.
| | - Concezio Di Rocco
- Department of neurosurgery, International Neuroscience Institute, Rudolf Pichlmayr Str. 4, 30625, Hannover, Germany
| |
Collapse
|
9
|
|
10
|
McPheeters MJ, Kainth DS, Lam CH. Spontaneous frontal intradiploic meningoencephalocele. Surg Neurol Int 2015; 6:S651-4. [PMID: 26713172 PMCID: PMC4683796 DOI: 10.4103/2152-7806.171221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/08/2015] [Indexed: 12/02/2022] Open
Abstract
Background: Since 1976, 10 cases of intradiploic encephaloceles have been reported in the literature. This case is the first report of a spontaneous intradiploic meningoencephalocele of the frontal bone hypothesized to be secondary to distant head trauma. Case Description: A 60-year-old female with a history of multiple traumatic head injuries as a child presenting with new onset generalized tonic-clonic seizures. Work-up revealed a right frontal epileptic focus. Imaging showed a right frontal intradiploic lesion. The patient underwent surgical resection, which during exploration was found to be an intradiploic encephalocele. She had an uneventful postoperative course with a resolution of seizures. Conclusions: The authors hypothesize that the rare nature of posttraumatic frontal intradiploic encephaloceles is due to the increased thickness of the frontal bone compared to the parietal bone.
Collapse
Affiliation(s)
| | - Daraspreet S Kainth
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Cornelius H Lam
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota 55455, USA
| |
Collapse
|
11
|
Arevalo-Perez J, Millán-Juncos JM. Parietal intradiploic encephalocele: Report of a case and review of the literature. Neuroradiol J 2015; 28:264-7. [PMID: 26246093 DOI: 10.1177/1971400915592554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Encephaloceles consist of brain tissue and meninges that has herniated through a skull defect, usually located in the midline. They are seen more commonly in children and very rarely in adults. We present a case of an 84-year-old patient who was incidentally diagnosed with a lytic bone lesion in the right parietal intradiploic space, after computed tomography of the head was performed. A magnetic resonance imaging scan of the brain showed herniation of brain tissue through the defect. Magnetic resonance imaging was crucial in demonstrating the presence of parenchyma and its continuity with the rest of the brain, consequently distinguishing it from other entities. We report the imaging findings of a parietal indradiploic encephalocele with its differential diagnosis and a review of the relevant literature.
Collapse
Affiliation(s)
- Julio Arevalo-Perez
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | |
Collapse
|
12
|
Rawal RB, Sreenath SB, Ebert CS, Huang BY, Dugar DR, Ewend MG, Sasaki-Adams D, Senior BA, Zanation AM. Endoscopic sinonasal meningoencephalocele repair: a 13-year experience with stratification by defect and reconstruction type. Otolaryngol Head Neck Surg 2015; 152:361-8. [PMID: 25645526 DOI: 10.1177/0194599814561437] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Sinonasal meningoencephalocele is a rare defect, with varying etiologies and treatment strategies. Here we present the largest published series from a single institution of patients with endoscopic repair. The primary goal is to examine rates of success with consideration to accompanying patient demographic data. The secondary goal is to report the results stratified by defect and reconstruction type. DESIGN Retrospective consecutive case series. SETTING Tertiary care academic center. SUBJECTS AND METHODS Consecutive patients with CPT codes for skull base meningoencephalocele repair between May 2000 and March 2013 were reviewed. Patients who specifically had sinonasal defects were included. RESULTS During the study period, 149 cases of sinonasal meningoencephaloceles were managed in 133 patients. Mean follow-up was 21.3 months (range, 0-116). There was a success rate of 88% for initial repair, with mean recurrence time of 8.3 months (range, 0-38), and a success rate of 93.8% for initial recurrence surgery, with 99.3% of ultimate successful repair. All cases were repaired endoscopically. Recurrence rate was not significantly related to location of defect (P = .682), size of defect (P = .434), particular reconstruction technique (P = .163), or etiology (trauma, P = .070). Overall complication rate was 11.3%. CONCLUSION Endoscopic sinonasal meningoencephalocele repair has excellent long-term results and may be considered as a primary approach. Surgeon comfort with a particular technique should be the most important factor used to guide choice of reconstruction.
Collapse
Affiliation(s)
- Rounak B Rawal
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Satyan B Sreenath
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Benjamin Y Huang
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Deepak R Dugar
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew G Ewend
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Deanna Sasaki-Adams
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Adam M Zanation
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
13
|
Mahaney KB, Menezes AH. Intradiploic occipital pseudomeningocele in a patient with remote history of surgical treatment of Chiari malformation. J Neurosurg Spine 2014; 21:769-72. [PMID: 25147975 DOI: 10.3171/2014.6.spine13785] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
An intradiploic CSF pseudocyst is a rare entity that has been described in association with trauma, as a sequela of untreated hydrocephalus, or occasionally as a congenital finding in older adults. The authors present the case of a woman with a remote history of a posterior fossa intradural procedure, in which she underwent Chiari malformation decompression, Silastic substitute–assisted duraplasty, and occipitocervical fusion; she presented 19 years later with recurrent symptoms of Chiari malformation. She was found to have an occipital intradiploic pseudomeningocele, arising within her dorsal occipitocervical fusion mass and resulting in dorsal hindbrain compression. She underwent a posterior fossa decompression and revision of her failed duraplasty, and she had a good recovery. This case demonstrates intradiploic CSF pseudomeningocele as a rare potential delayed complication of an intradural procedure for the treatment of Chiari malformation with occipitocervical fusion.
Collapse
|
14
|
Abstract
The management of intradiploic CSF collection is controversial. Although it is a benign lesion, even then delay in diagnosis and treatment may lead to significant morbidity. The authors report a very rare case of giant posttraumatic intradiploic pseudomeningocele involving the occipital bone, occipital condyles, and clivus. The pathogenesis and management of intradiploic CSF collection are discussed. This 16-year-old boy presented with a history of enlarging swelling in the suboccipital region associated with headache, lower cranial nerve palsy, and features of high cervical compressive myelopathy. Investigations revealed a giant intradiploic lesion involving the occipital bone, condyles, and clivus associated with secondary basilar invagination, hydrocephalus, and syringomyelia. Intrathecal contrast administration did not reveal communication of intradiploic space with the subarachnoid space. A large occipital craniotomy was performed. A linear fracture and dural defect in the midline was identified, which was closed with fascial graft after removing the inner table of the skull. Cranioplasty was performed using the expanded calvarial bone. Ventriculoperitoneal shunt insertion was performed for hydrocephalus, and the patient improved remarkably. Posttraumatic intradiploic CSF collection, although a benign condition, may present with severe complications if treatment is delayed. Early diagnosis and treatment is essential. The authors suggest that this condition should be treated early, as for growing skull fractures.
Collapse
Affiliation(s)
- Rajinder Kumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | | | | |
Collapse
|
15
|
Comments to Esparza et al's article "Surgical treatment of isolated and syndromic craniosynostosis. Results and complications in 283 consecutive cases". Neurocirugia (Astur) 2008; 19:507-8. [PMID: 19112544 DOI: 10.1016/s1130-1473(08)70200-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
16
|
Tsuboi Y, Hayashi N, Noguchi K, Kurimoto M, Nagai S, Endo S. Parietal Intradiploic Encephalocele-Case Report-. Neurol Med Chir (Tokyo) 2007; 47:240-1. [PMID: 17527054 DOI: 10.2176/nmc.47.240] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 66-year-old man presented with a parietal intradiploic encephalocele manifesting as dizziness in June 2001. Skull radiography showed lytic change involving the right parietal bone. Computed tomography with bone window showed bone destruction associated with the right frontal lesion. Magnetic resonance imaging demonstrated a lesion in the parietal intradiploic space continuous with the right frontal lobe. The lesion was located near the central sulcus, so surgical biopsy carried the risk of motor dysfunction. Single photon emission computed tomography (SPECT) showed the same pattern of cerebral blood flow as normal brain tissue, so the neuroimaging diagnosis was encephalocele. The present case indicates that surgery may not be necessary in the absence of symptoms and neurological deficits. SPECT is very useful to identify encephalocele.
Collapse
Affiliation(s)
- Yoshifumi Tsuboi
- Department of Neurosurgery, Faculty of Medicine, University of Toyama, Japan
| | | | | | | | | | | |
Collapse
|
17
|
Placantonakis DG, Lis E, Souweidane MM. Intradiploic cerebrospinal fluid fistulas of iatrogenic origin. Report of two cases. J Neurosurg 2006; 104:356-9. [PMID: 16848095 DOI: 10.3171/ped.2006.104.5.356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intradiploic cerebrospinal fluid (CSF) collections represent a rare complication of either head trauma or neurosurgical procedures. Their formation is thought to depend partly on violation of the meninges and the inner cortical bone abutting the neuraxis. The authors present two pediatric cases involving diploic CSF collections following neurosurgical interventions. In the first case, a CSF fistula was found within the occipital bone and the petrous portion of the temporal bone 9 years after a suboccipital craniectomy. The second case features the extremely rare occurrence of a CSF fistula within a thoracic vertebra, 9 years after a laminectomy. Both patients underwent successful surgical procedures for repair of the fistulas.
Collapse
Affiliation(s)
- Dimitris G Placantonakis
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York 10021, USA
| | | | | |
Collapse
|
18
|
Hamamcioglu MK, Hicdonmez T, Kilincer C, Cobanoglu S. Large intradiploic growing skull fracture of the posterior fossa. Pediatr Radiol 2006; 36:68-70. [PMID: 16249888 DOI: 10.1007/s00247-005-0012-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Revised: 08/15/2005] [Accepted: 08/16/2005] [Indexed: 10/25/2022]
Abstract
Growing skull fractures (GSFs) are rare complications of head injury and mostly occur in infancy and early childhood. Location in the posterior fossa and intradiploic development of a GSF is very uncommon. We report a 7-year-old boy with a large, 9 x 7 x 4-cm, occipital intradiploic GSF. The lesion developed progressively over a period of 5 years following a documented occipital linear fracture. This case of a GSF developing from a known occipital linear fracture demonstrates that a GSF may reach a considerable size and, although uncommon, intradiploic development and occipital localization of a GSF is possible.
Collapse
Affiliation(s)
- M Kemal Hamamcioglu
- Department of Neurosurgery, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
| | | | | | | |
Collapse
|
19
|
Comentario al trabajo: Fractura evolutiva de cráneo en la infancia. Presentación de 12 casos de R. Mierez y cols. Neurocirugia (Astur) 2003. [DOI: 10.1016/s1130-1473(03)70543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
20
|
Escudero R, Pérez I, Roldán F, Canabal A. Fractura craneal evolutiva. Extensión intradiploica occipital del quiste leptomeníngeo. RADIOLOGIA 2001. [DOI: 10.1016/s0033-8338(01)76976-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Gelabert González M, García Pravos A, Fernández Villa J, Cutrín Prieto J, Pérez Muñuzuri A. Quiste leptomeníngeo postraumático de larga evolución. Neurocirugia (Astur) 2000. [DOI: 10.1016/s1130-1473(00)70967-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|