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. Giant intraspinal pseudomeningoceles cause delayed neurological dysfunction after brachial plexus injury: report of three cases.OBJECTIVE AND IMPORTANCE: Delayed neurological dysfunction after a brachial plexus injury is uncommon. We present the cases of three patients with a history of significant brachial plexus trauma and late neurological deterioration secondary to giant intraspinal extradural pseudomeningoceles. CLINICAL PRESENTATION: Three patients, each with a remote history of brachial plexus trauma, presented with slowly progressive upper-limb weakness. An examination revealed bilateral lower motor neuron weakness in the upper extremities in all patients and evidence of spastic paraparesis in one. magnetic resonance imaging and postmyelogram computed tomographic scans demonstrated large anterior extradural cerebrospinal fluid collections extending from the upper cervical to lower thoracic and lumbar levels in each patient. Myelograms demonstrated a connection with the subarachnoid space in two patients. INTERVENTION: Direct obliteration of the connection between the cyst and the subarachnoid space was completed in two patients, and a cystoperitoneal shunt was placed in the third. Postoperative imaging demonstrated complete resolution of the extradural collections. Arrest of progression of upper-limb deterioration was observed in all patients, and dramatic improvement of long tract symptoms occurred in one. CONCLUSION: Giant intraspinal pseudomeningoceles are a rare complication of brachial plexus root injuries or avulsion, capable of causing significant morbidity. Early intervention can improve symptoms related to long tract involvement and prevent further deterioration of lower motor neuron disease. The pathophysiology of neurological dysfunction caused by these giant collections is unclear; however, vascular and mechanical factors thought to be important in the pathogenesis of cervical myelopathy also may have a role.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
3/11. Intrathoracic giant meningocele developing hydrothorax: a case report.A 67-year-old woman with neurofibromatosis type 1 presented with progressive dyspnea. Radiologic evaluation and magnetic resonance imaging revealed progression of a giant meningocele associated with hydrothorax. Laminoplasty with incision of the meningocele and dural plasty was performed, although nerve rootlets were killed. Microsurgical incision of the neck of the meningocele is a favorable operation even in large meningoceles such as the present case.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
4/11. Giant intrathoracic meningoceles associated with cutaneous neurofibromatosis type I: case report.BACKGROUND: Intrathoracic meningocele is a rare pathology, almost always associated with neurofibromatosis type I and with a few cases related in the literature. In the majority of cases cysts are small or asymptomatic, and the surgery is indicated when big or symptomatic cysts are present. We report a case of giant intrathoracic cysts surgically extirpated through out thoracotomy. CASE: A 59-year-old male with familiar Von Recklinghausen's disease which developed thoracic radicular pain after a fall. On examination he presented some difficulty in walking fast and dyspneia on small efforts. The chest plain x-ray showed the presence of 3 huge left side intrathoracic cysts (10 to 15cm). The patient was submitted to a surgical treatment and complete extirpation of the cysts was performed through a left side thoracotomy. During the surgery a fourth smaller cyst was detected and also extirpated. Evolution was uneventful and the patient remains well in these last 12 years. This finding of intrathoracic cysts related to neurofibromatosis type I is rare and is probably unique in the literature the presence of 4 huge cysts in one side of the thorax.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
5/11. 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) |
6/11. Endoscopic cure of a giant sacral meningocele associated with Marfan's syndrome: case report.An unusual anterior sacral meningocele associated with Marfan's syndrome, with demonstrated dural anomalies related to Marfan's syndrome is reported. endoscopy enabled complete exploration of the meningocele, its morphological description, and ultimate cure. The meningocele resembled an hourglass made up of intrasacral and anterior sacral components. The communication of this bilobed malformation with the dural sac was so small that only the intrathecal injection of a colored solution allowed its localization. The closure of this communication was accomplished under endoscopic view by a single stitch. The postoperative course of the patient was characterized by immediate disappearance of the preoperative clinical signs. Computed tomographic scans demonstrated progressive complete collapse of the anterior sacral meningocele and partial resolution of the intrasacral component. Dural anomalies of Marfan's syndrome are described, and their relationship to the formation of the meningocele is discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/11. Resection of a giant anterior sacral meningocele via an anterior approach: case report and review of literature.BACKGROUND: An anterior sacral meningocele is a rare form of spinal dysraphism that is sometimes associated with syndromes such as Currarino and Marfan syndromes. These lesions rarely cause neurological complications, but meningitis, sepsis, obstetric problems, and bowel and bladder difficulties are common secondary conditions. The lesions can even be fatal. Because these lesions usually do not regress spontaneously, surgical treatment is the standard for symptomatic or growing masses. The dural defect can be repaired with a variety of anterior or posterior approaches. CASE DESCRIPTION: We present a case of a 16-year-old female patient with a giant nonsyndromic anterior sacral meningocele that we successfully treated using an open anterior approach. We discuss the treatment options and present a brief review of the literature. CONCLUSIONS: Although the posterior approach remains the treatment of choice for most lesions, we believe that the anterior laparotomy provides excellent exposure and is a safe alternative approach for the treatment of selected lesions. patients with these lesions should be cared for by a multidisciplinary team.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
8/11. Anterior-sacral meningocele; value of magnetic resonance imaging and abdominal sonography. A case report.With the presentation of a case of giant anterior sacral meningocele, the evident superiority of magnetic resonance imaging over any other methods for the diagnosis of this rare condition is demonstrated. Ultrasound as a screening tool is often the first to reveal the presence of the intrabdominal cystic abnormality and furthermore is an excellent means for checking the post-operative course. In addition this particular case is interesting because the dural stalk linking the meningocele to the dural abdominal sac was not entirely free from nervous structures inspite of macroscopic appearances to the contrary.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
9/11. Giant anterior lumbosacral meningocele associated with intracranial meningiomas and multiple congenital malformations.A case of anterior meningocele arising through a thin fistulous tract in the intervertebral disk space of L5-S1 is described. This lesion was giant, and almost completely filled the abdominal and pelvic cavities. Furthermore, it was associated with two separate intracranial meningiomas, a pleuropericardial cyst, and numerous developmental malformations. Pathogenetic factors, clinical and radiological features, and surgical treatment are discussed.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
10/11. 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) |
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