1/219. Idiopathic temporal encephalocele: report of two cases.BACKGROUND: Idiopathic brain herniation into the middle ear is a rare condition that represents diagnostic and therapeutic challenges. OBJECTIVE: The authors present here two new cases of idiopathic brain herniation with special clinical presentation and emphasis on radiographic studies, particularly computed tomographic scan and magnetic resonance imaging, which allowed the authors to detect the malformation. RESULTS: The two patients underwent surgical treatment with infratemporal approach and recovered perfectly.- - - - - - - - - - ranking = 1keywords = herniation (Clic here for more details about this article) |
2/219. Meningoencephalic herniation into the middle ear.Meningoencephalic herniation into the middle ear (MHME) is a rare condition. It can result from ear surgery, infection, head trauma or can be spontaneous. diagnosis requires a high degree of clinical suspicion. The presentation may suggest the condition, but sometimes the intraoperative discovery of an occult meningoencephalic herniation may be a frightening situation. Treatment planning must avoid intra-cranial complications. Transmastoid (TM) and middle cranial fossa (MCF) are alternative or complementary approaches, determined by several factors, including the size and the site of the bony defect and the presence or absence of middle ear infection. Three case reports are presented and a review of the literature is performed, to explain some aspects related to MHME, including aetiopathogenesis, clinical presentation, histopathology, diagnosis and treatment.- - - - - - - - - - ranking = 3keywords = herniation (Clic here for more details about this article) |
3/219. 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 = 0.13469034332982keywords = meningocele (Clic here for more details about this article) |
4/219. Spontaneous closure of bony defect in a frontoethmoidal encephalomeningocele patient.The frontoethmoidal encephalomeningocele (FEEM) is a congenital herniation of meninges and brain tissue through the skull bony defect at the foramen cecum. The size of the defect may vary from a few millimeters to many. Those patients with a small defect may not always require a risky operation during childhood. We report on an infant whose bony defect has closed spontaneously with definite clinical evidence. It is proved that the skull defect and brain herniation are able to heal naturally, and this affirms an existence of the abortive subtype of FEE. Conservative treatment may be considered in those with a small bony defect, and surgery can be considered later when it is required.- - - - - - - - - - ranking = 1.1683629291623keywords = herniation, meningocele (Clic here for more details about this article) |
5/219. Postpartum cerebellar herniation in von Hippel-Lindau syndrome.PURPOSE: To describe exacerbation during pregnancy of cerebellar hemangioblastoma in von Hippel-Lindau syndrome. METHOD: Case-report. A 21-year-old woman with von Hippel-Lindau syndrome was found on routine ocular examination to have severe papilledema 1 week after giving birth. RESULTS: Immediate magnetic resonance imaging disclosed a large cerebellar cyst from hemangioblastoma causing cerebellar tonsillar herniation. Immediate neurosurgical intervention was life saving. CONCLUSION: Worsening of intracranial hemangioblastoma during pregnancy in cases of von Hippel-Lindau syndrome should be realized and periodic neurologic and ophthalmologic observation is warranted.- - - - - - - - - - ranking = 2.5keywords = herniation (Clic here for more details about this article) |
6/219. Central brain herniation secondary to juvenile diabetic ketoacidosis.We present the CT, MR, and autopsy findings of central brain herniation in a 9-year-old boy undergoing treatment for diabetic ketoacidosis (DKA). Severe cerebral edema resulting in central brain herniation is an uncommon complication of the treatment of DKA but carries with it high morbidity and mortality. Radiologic imaging and autopsy findings in this case revealed striking infarctions of central brain structures.- - - - - - - - - - ranking = 3keywords = herniation (Clic here for more details about this article) |
7/219. Vertex hemangioma mimicking an encephalocele.Most extracranial masses detected prenatally by use of ultrasonography are either encephaloceles or meningoceles. This article describes an extracranial mass detected prenatally that was initially thought to be an encephalocele, but was subsequently found to be a large hemangioma.- - - - - - - - - - ranking = 0.033672585832454keywords = meningocele (Clic here for more details about this article) |
8/219. Cerebral herniation after lumbar puncture in sarcoid meningitis.A patient with chronic meningitis due to neurosarcoidosis became comatose within minutes of a lumbar puncture and died 24 h later. The diagnosis of neurosarcoidosis was made post mortem. Development of cerebral herniation may have been exacerbated by lumbar puncture. It was proposed that arachnoid villi dysfunction may have contributed to very high intracranial pressures in this patient, since post mortem examination revealed communication between the ventricles and outlet foramina of the fourth ventricle, and that herniation was in part due to an acute pressure differential caused by lumbar puncture.- - - - - - - - - - ranking = 3keywords = herniation (Clic here for more details about this article) |
9/219. Neuroradiology of basal anterior fossa (transethmoidal) encephaloceles.Encephaloceles of the basal anterior fossa, though primarily congenital in origin, may be insidious in presentation and remain undetected until adulthood. Conventional plain films and hypocycloidal tomograms show a basal osseous defect with its margins bevelled toward the nasopharynx. Magnification angiography is the diagnostic study of choice and reveals herniation of the anterior inferior frontal artery through the osseous defect. pneumoencephalography, the classical technique of investigation, was found to be unrewarding in demonstrating the herniated sac or in determining the presence or absence of brain tissue within the sac; however, it is of value in demonstrating a ventricular communication with the encephalocele and evaluating ventricular dilatation.- - - - - - - - - - ranking = 0.5keywords = herniation (Clic here for more details about this article) |
10/219. Transsphenoidal cephaloceles in adults. A report of two cases and review of the literature.Transsphenoidal cephalocele rarely occurs in adults. We describe two adult cases with transsphenoidal cephaloceles. The first case was a 53-year-old female who presented with spontaneous cerebrospinal fluid (CSF) rhinorrhea. Magnetic resonance (MR) imaging demonstrated a transsphenoidal meningocele. Surgical repair was attempted via the transsphenoidal route. Rhinorrhea recurred at one month and also two years later. Transsphenoidal surgical repairs were repeated. There has been no evidence of CSF leakage in the four years of follow-up after the last surgery. Transsphenoidal repair seems to be the most suitable approach in this case. The second case was a 26-year-old female with secondary amenorrhea, diabetes insipidus, bitemporal hemianopsia, and see-saw nystagmus. MR imaging demonstrated a transsphenoidal encephalocele with the optic chiasma and infundibular recesses descending into the meningocele and an agenesis of the corpus callosum. The first operation was performed via the transnasal route and the second by sublabial transmaxillary transsphenoidal approach six months later. Postoperative MR imaging revealed reduction of the encephalocele. There was neither worsening nor noticeable improvement in the neurological or endocrinological function. However, in this type, complete repair is often impossible, and non-radical surgery such as transsphenoidal repair may be indicated as most suitable. They should be selected with careful assessment referring to MR findings and clinical symptoms and signs.- - - - - - - - - - ranking = 0.067345171664909keywords = meningocele (Clic here for more details about this article) |
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