1/11. Craniofacial correction of giant frontoethmoidal encephalomeningocele.The surgical treatment of a very large anterior encephalocele in an infant is presented. Because of the large size of the encephalocele, a combined transfacial-transcranial approach was used for correction of the associated intracranial, cranioorbitonasal bone, and facial skin deformities.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/11. Craniofacial reconstruction of a giant cystlike temporal encephalocele.A 4-year-old girl underwent craniofacial reconstruction for giant cystlike encephalocele deriving from the temporo-maxillary region and giving impression of the duplicated head. The case of temporal encephalocele in this report is especially unusual in the extent of encephalocele, the degree to which it had expanded the zygomatic arch, mandible, cranial vault, and the radiologically undetectable bony defect. The use of craniofacial principles in the resection and reconstruction of the temporal encephalocecle are described.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
3/11. Posterior fontanelle giant encephalocele.A 4-day-old baby was admitted with a large posterior fontanelle encephalocele. The baby was the third child of a consanguineous marriage. Two older siblings, 5 and 3 years old, were normal. The baby had a small head with a circumference of 30 cm only and an encephalocele with a circumference of 37 cm. The baby was active and there was no other neural tube defect or any other congenital anomalies. Noncontrast CT scan of the head with bone window showed a large posteriorly located encephalocele above the occipital bone, containing a small amount of brain tissue and a large volume of CSF. The baby was operated on in the lateral position and the encephalocele was excised. The dural defect was closed directly. The baby had an uneventful postoperative recovery. Twenty months later, the baby was well with no gross neurological deficits.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/11. Craniofacial surgery for giant frontonasal encephalocele in a neonate.A 5-day-old neonate with a frontonasal encephalocele is reported. He was referred to our institute with a swelling on the glabella not associated with cerebrospinal fluid (CSF) leak. The baby was the first born of a non-consanguinous marriage. The baby had a swelling over the glabella, 7 cm in diameter. The swelling had healthy covering with a raw area at the centre without any CSF leak. A magnetic resonance imaging scan showed a soft tissue swelling containing tissue iso-intense to normal brain. The internal bony defect was at the junction of the frontal and ethmoid bones, in front of the crista galii, in the floor of the anterior cranial fossa. The baby was operated on the 11th day after birth. A one-stage repair of encephalocele was performed, along with correction of hypertelorism and reconstruction of the nasal bridge. The postoperative period was unremarkable. The baby was discharged from hospital on the 10th postoperative day.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/11. Microvascular reconstruction of a giant encephalocele defect in a 10-week-old infant.Microvascular reconstruction of a cranial defect in a 10-week-old infant, which is the youngest case in the literature, is reported. A latissimus dorsi free muscle flap was transferred to cover the defect and a split thickness skin graft was placed over the muscle flap. Despite the successful flap transfer in this case, microvascular reconstruction in an infant has its own risks and infants should be discussed as a separate entity apart from the other pediatric patients.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/11. Neurocutaneous melanosis associated with Dandy-Walker malformation and a meningohydroencephalocele. Case report.Neurocutaneous melanosis and Dandy-Walker malformation are both forms of rare congenital neurodysplasia. Interestingly, 8 to 10% of patients with neurocutaneous melanosis also harbor an associated Dandy-Walker malformation, indicating that these developmental abnormalities share a common origin. The authors describe a case of neurocutaneous melanosis associated with Dandy-Walker malformation and an occipital meningohydroencephalocele with a giant melanotic nevus. Multiple congenital liver masses were also observed in the infant. The occipital nevus was totally excised, and ventriculoperitoneal and cyst-peritoneal shunts were created to prevent subsequent hydrocephalus. Findings in this case support the possibility that excessive melanocytes hinder normal mesenchymal development, causing Dandy-Walker malformation and an occipital meningocele.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
7/11. Acute subdural hematoma caused by an unruptured, thrombosed giant intracavernous aneurysm.INTRODUCTION: Acute subdural hematoma (SDH) is an infrequent complication after aneurysmal subarachnoid hemorrhage. SDH associated with unruputed intracavernous aneurysm has never been reported. methods: Single patient case report and review of relevent literature. RESULTS: A 65-year-old woman with an unruptured, thrombosed giant intracavernous aneurysm developed an acute SDH 2 days after admission for cavernous sinus syndrome. Despite emergent evacuation of the SDH, the patient never regained consciousness because of brain herniation. CONCLUSION: Acute SDH is a rare complication of ruptured, giant intracavernous aneurysms. Erosion of the cavernous sinus wall by acute enlargement of the aneurysm after thrombosis is the proposed mechanism for development of the SDH.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
8/11. dandy-walker syndrome forming a giant occipital meningocele--case report.A boy was born with dandy-walker syndrome associated with a giant occipital meningocele, cleft lip, and cleft palate. The meningocele was actually a component of the giant posterior fossa cyst which communicated with the fourth ventricle. A cyst-peritoneal shunt achieved a considerable decrease in the size of the meningocele, but decubital ulcers developed due to restricted head movement caused by the occipital lesion. Cranioplasty removed a wide area of the inferior occipital bone, and the boundary between the superior occipital and parietal bones was thinned to allow free bending of the bone flap. The meningocele was removed totally in the third operation, but infection of the wound and pneumonia developed, causing death. The coexistence of dandy-walker syndrome and occipital meningocele, together with midline facial anomalies, may suggest a later pathogenesis of dandy-walker syndrome than previously believed.- - - - - - - - - - ranking = 1.5keywords = giant (Clic here for more details about this article) |
9/11. Nasal glioma: an immunohistochemical and ultrastructural study.A case of a 14 month old Japanese female infant presenting with nasal glioma is reported. The tumor had been noticed at the nasal radix since birth and had slowly and progressively enlarged. There was no communication between the tumor and the cranial cavity on radiological examination. The tumor was macroscopically anchored to the nasal septum by a fibrous stalk, and histologically consisted of nests or trabeculae of either polygonal or spindle cells with plump eosinophilic cytoplasm and oval nuclei, separated by vascular-rich connective tissue intermingled with multinucleated giant cells. These tumor cells were immunohistochemically positive for glial fibrillary acidic protein as well as for S-100 protein and vimentin. An electron microscopic examination revealed collagen fibers and basal lamina between the tumor cells and the fibroblasts. Tumor cells possessed abundant intermediate filaments, which showed occasional Rosenthal fiber-like structures, in their cytoplasm and processes. A few oligodendrocytes and cilia of 9 microtubule doublets either with or without 2 central microtubules were also noted. These clinicopathological findings suggested that this tumor was once an encephalo(meningo)cele, which probably degenerated as a result of the loss of intracranial communication and then appeared to be isolated from the intracranial tissue.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
10/11. Giant congenital nevocellular nevus overlying an encephalocele.Discussion regarding the diagnosis, prognosis, and management of giant congenital nevocellular nevi (GCNN) has permeated the literature because of concerns regarding malignant potential. As a derivative of dysgenetic neural crest development, GCNN histology in the neonate may be quite variable and not easily discernible from malignant melanoma, presenting a diagnostic dilemma to both the seasoned pathologist and surgeon. Here we present an interesting case of GCNN arising from a large encephalocele in a neonate. In spite of a clinically aggressive course, histology repeatedly failed to meet the criteria for melanoma until the diagnosis of malignant melanoma was made at autopsy. Clinical suspicion for malignancy must be high when evaluating atypical large nevi, and prompt surgical management is necessary to protect against the risk for malignant melanoma.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
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