1/21. Transnasal endoscopic repair of congenital defects of the skull base in children.OBJECTIVE: To examine imaging findings and methods of endoscopic treatment of congenital skull base defects in children. DESIGN: Retrospective study and case series. SETTING: Academic tertiary care center. patients: Four patients (aged 12 and 14 months and 8 and 13 years) were included from 1995 to 1997. Three presented with a nasal glioma, which was recurrent in 1 case. The fourth patient presented with bacterial meningitis due to a spontaneous cerebrospinal fluid leak. Computed tomography and magnetic resonance imaging were used to locate the defect of the skull base. INTERVENTION: Transnasal endoscopic resection of the glioma or the meningocele, with immediate repair of the skull base defects using free mucosal flaps and/or pediculized mucosal flaps and/or conchal cartilage together with fibrin glue and nasal packing during a 3-week period. RESULTS: None of the 4 patients has experienced recurrent cerebrospinal fluid leaks or postoperative meningitis. CONCLUSIONS: The transnasal endoscopic repair of congenital meningoceles is a reliable technique in select pediatric patients. Computed tomography and magnetic resonance imaging provide information that can be used to help the surgical procedure.- - - - - - - - - - ranking = 1keywords = meningocele (Clic here for more details about this article) |
2/21. Sternberg's canal--cause of congenital sphenoidal meningocele.We present a case of a 29-year-old female complaining of right-sided watery nasal discharge. Radiological investigations identified an intrasphenoidal meningocele. The origin of the meningocele was pinpointed to the right parasellar region and was confirmed surgically. The parasellar bony defect appeared to be due to persistence of the lateral craniopharyngeal canal (Sternberg's canal). Therefore, we assume a congenital origin for the intrasphenoidal meningocele found in the patient. Acquired bony defects of the sphenoid sinus are unlikely at the fusion planes of the different sphenoid bone components. knowledge of the complex ontogeny of the sphenoid bone is an important key to differentiating between congenital and acquired sphenoid sinus meningoceles.- - - - - - - - - - ranking = 4keywords = meningocele (Clic here for more details about this article) |
3/21. Recovery from Duret hemorrhage: a rare complication after craniotomy--case report.A 44-year-old female presented with Duret hemorrhage due to transtentorial herniation by extradural hematoma as a complication after craniotomy for treatment of spontaneous middle cranial fossa cerebrospinal fluid leakage through the oval window. brain computed tomography revealed linear hemorrhage in the midbrain and the rostral pons. She awoke after 2 weeks in a coma, despite showing ocular bobbing and bilateral intranuclear ophthalmoplegia. She was discharged from the hospital with minimal neurological defects. Duret hemorrhage is usually fatal, but this case shows that early surgical decompression is the most important factor to avoid the worst sequelae.- - - - - - - - - - ranking = 0.028004845489049keywords = herniation (Clic here for more details about this article) |
4/21. Spontaneous CSF rhinorrhoea from separate defects of the anterior and middle cranial fossa.Multiple congenital dehiscence of the skull base is rare and can give rise to spontaneous CSF rhinorrhoea. A search of the world literature revealed only five reports of CSF leak with more than one concomitant skull base defect. When treating a patient with spontaneous CSF rhinorrhoea the possibility of its originating from the middle ear and eustachian tube should be considered. An intrathecal injection of fluorescein is useful in establishing the site of a CSF leak especially when a computed tomography scan (CT) or magnetic resonance image (MRI) has not localized the site. We discuss a case of a 72-year-old lady presenting with CSF rhinorrhoea, who had an anterior skull base defect localized with the help of intrathecal fluorescein and repaired surgically. Subsequent to this she had a further episode of CSF rhinorrhoea that originated from a middle-ear meningocele that was then repaired.- - - - - - - - - - ranking = 0.5keywords = meningocele (Clic here for more details about this article) |
5/21. Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula.Spontaneous cerebrospinal rhinorrhea is a rare clinical condition. More commonly it develops due to cerebral tumors or hydrocephalus; it is seldom seen in association with empty sella syndrome. A sixty-three-year-old woman who presented with left nasal discharge was hospitalized on the suspicion of CSF rhinorrhea. Analysis of the nasal fluid revealed a clear color, a positive Pandy's test, and a positive result for glucose (72%). On magnetic resonance scans, herniation of the suprasellar cistern was observed into the sellar cavity, and the left sphenoid sinus was filled with contrast medium. The repair of the fistula was performed via a transnasal and transsphenoidal approach. The patient was followed-up for five years without any symptoms or recurrences.- - - - - - - - - - ranking = 0.028004845489049keywords = herniation (Clic here for more details about this article) |
6/21. Chronic post-traumatic erosion of the skull base.Delayed post-traumatic erosion of the skull base is reported in three patients who presented as adults with cerebrospinal fluid fistulae and a history of recurrent meningitis. These skull defects were associated with herniation of the subarachnoid space into the diploe of the skull base, the paranasal sinuses and the orbit. This rare complication of head injury is assumed to have occurred as the result of a dural tear at the time of trauma. Its site probably determines whether a resulting meningocele widens the intradiploic space or broaches the cranial floor.- - - - - - - - - - ranking = 0.52800484548905keywords = meningocele, herniation (Clic here for more details about this article) |
7/21. empty sella syndrome, diagnosed as allergic rhinitis.Unilateral cerebrospinal fluid (CSF) rhinorrhea as the only manifestation of the primary empty sella syndrome is a rare event. A case of a middle-aged male patient complaining for intermittent unilateral rhinorrhea, which started 5 months earlier, is reported. The persistence of this state was attributed to an allergic rhinitis. The initial work-up excluded the above diagnosis and an erroneous radiological diagnosis led to a puncture of the left maxillary sinus. A lateral X-ray of the skull and CT scan led to the diagnosis of empty sella syndrome, possibly due to an adenoma or a meningocele.- - - - - - - - - - ranking = 0.5keywords = meningocele (Clic here for more details about this article) |
8/21. Congenital transsphenoidal meningocele: case report and review of the literature.Intrasphenoidal meningoencephalocele is a rare clinical entity. Its origin can be congenital, traumatic, tumoral, or spontaneous. Presenting as cerebrospinal fluid fistula with rhinorrhea, the diagnosis and treatment of this uncommon disease is a real challenge for the otorhinolaryngologist. We report a case of sphenoidal meningocele treated using an endoscopic procedure and review the literature regarding its congenital origin.- - - - - - - - - - ranking = 2.5keywords = meningocele (Clic here for more details about this article) |
9/21. Encephalomeningocele presenting with spontaneous cerebrospinal fluid rhinorrhea in an elderly man: case report.The case of a patient with spontaneous cerebrospinal fluid (CSF) rhinorrhea from an intranasal encephalomeningocele is presented. The case is unusual in that the patient was entirely asymptomatic until the age of 65, when copious CSF rhinorrhea developed without trauma or operation as an inciting event. The pertinent literature is reviewed, and no identical case has been found.- - - - - - - - - - ranking = 2.5keywords = meningocele (Clic here for more details about this article) |
10/21. Spontaneous encephalocele of the temporal bone.Postsurgical and posttraumatic encephaloceles of the tegmen tympani and tegmen mastoideum are well-recognized occurrences. Less frequently recognized, however, is the spontaneous occurrence of an encephalocele associated with cerebrospinal fluid otorrhea or rhinorrhea. This cerebral herniation into the middle ear and the mastoid cavity in adults is associated with a loss of both bony and dural support, and surgical management must deal with both the cerebrospinal fluid leak and herniation of the brain.- - - - - - - - - - ranking = 0.056009690978099keywords = herniation (Clic here for more details about this article) |
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