1/23. 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 = 1keywords = herniation (Clic here for more details about this article) |
2/23. Double compartment hydrocephalus in a patient with cysticercosis meningitis.The authors discuss encystment of the fourth ventricle and upward herniation complicating a case of cysticercosis cerebri. The "double compartment" hydrocephalus followed occlusion of the aqueduct of Sylvius and the foramena of Luschka and Magendie in a patient who had previously received a ventriculo-atrial shunt for communicating hydrocephalus. The clinical presentation of this particular form of double compartment hydrocephalus is discussed.- - - - - - - - - - ranking = 0.16666666666667keywords = herniation (Clic here for more details about this article) |
3/23. Chronic meningitis presenting with acute obstructive hydrocephalus.A previously healthy 24-year-old woman presented to the Emergency Department unresponsive with a glasgow coma scale score of 4 and evidence of brainstem herniation. She was intubated and hyperventilated. Computed axial tomography scan of the brain demonstrated four-chamber hydrocephalus. Continued hyperventilation and mannitol diuresis were sufficient to arrest the impending herniation while emergent ventriculostomy was arranged. The patient recovered without sequelae and ultimately received a diagnosis of chronic idiopathic meningitis. This case highlights a rarely diagnosed disorder that presented with an acutely life threatening condition.- - - - - - - - - - ranking = 0.33333333333333keywords = herniation (Clic here for more details about this article) |
4/23. Two occult skull base malformations causing recurrent meningitis in a child: a case report.Occult malformations of the skull base are rare anomalies, but can cause severe complications such as meningitis. Detailed skull base investigations for detecting cerebrospinal fluid fistulas or celes are often not initiated until after a history of recurrent meningitis. We present a child first seen at the age of 12 with recurrent episodes of bacterial meningitis since early childhood, requiring antibiotic prophylaxis for years. High-resolution computed tomography revealed a chronic sinusitis and a bony defect on the right olfactory groove, while magnetic resonance imaging and CT-cisternography indicated no cerebrospinal fluid fistula or cele at that time. Endonasal surgery for chronic sinusitis was performed with a confirmed bony defect on the right olfactory groove and an olfactory fibre without its sleeve-like dura prolongation running into an adjacent ethmoidal cell, necessitating that it be covered. In the absence of any antibiotics a new episode of meningitis occurred 5 years after surgery. CT-cisternography and magnetic resonance imaging were repeated, now indicating a transclival bony defect with a meningocele in its proximal part, most probably presenting a canalis basilaris medianus. Endonasal surgery confirmed this bony defect after adenoidectomy, and closure was accomplished. No further meningitis has been observed for 2 years. Congenital skull base defects may be difficult to detect, but sufficient surgical closure after their precise delineation is mandatory to prevent infectious endocranial complications. The presence of more than one developmental skull base defect should be considered during careful radiological skull base evaluation, which has to include the clivus in order not to overlook rare basilar malformations.- - - - - - - - - - ranking = 1.3400016391106keywords = meningocele (Clic here for more details about this article) |
5/23. Anterior sacral meningocele: report of five cases and review of the literature.Five new cases of anterior sacral meningocele are presented, including one secondary to neurofibromatosis, a previously undescribed association. The literature is reviewed, drawing attention to the relationship between anterior sacral meningocele, sacral dysgenesis, and other congenital anomalies. Special consideration is given to the clinical features of this entity, as well as to the techniques and results of surgical management.- - - - - - - - - - ranking = 8.0400098346639keywords = meningocele (Clic here for more details about this article) |
6/23. 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 = 1.5066683057773keywords = meningocele, herniation (Clic here for more details about this article) |
7/23. Recurrent meningitis associated with complete Currarino triad in an adult--case report.A 58-year-old woman presented with Currarino triad manifesting as recurrent meningitis. Currarino triad is a combination of a presacral mass, a congenital sacral bony abnormality, and an anorectal malformation, which is caused by dorsal-ventral patterning defects during embryonic development. She had a history of treatment for anal stenosis in her childhood. Radiographic examinations demonstrated the characteristic findings of Currarino triad and a complicated mass lesion. The diagnosis was recurrent meningitis related to the anterior sacral meningocele. neck ligation of the meningocele was performed via a posterior transsacral approach after treatment with antibiotics. At surgery, an epidermoid cyst was observed inside the meningocele. The cyst content was aspirated. She suffered no further episodes of meningitis. The meningitis was probably part of the clinical course of Currarino triad. radiography of the sacrum and magnetic resonance imaging are recommended for patients with meningitis of unknown origin. The early diagnosis and treatment of this condition are important.- - - - - - - - - - ranking = 4.0200049173319keywords = meningocele (Clic here for more details about this article) |
8/23. meningocele with cervical dermoid sinus tract presenting with congenital mirror movement and recurrent meningitis.Dermoid sinuses and meningoceles are seldom encountered in the cervical region. Besides, to the best of our knowledge, the coexistence of these types of congenital abnormalities with recurrent meningitis, as well as with mirror movement, has never been reported before. A 14-year-old female with the diagnosis of recurrent meningitis was referred to our clinic from the Department of Infectious Diseases. She had a cervical meningocele mass that was leaking cerebro-spinal fluid (CSF) and an associated mirror movement symptom. Spina bifida, dermoid sinus and meningocele lesions were demonstrated at the C2 level on computed tomography (CT) and magnetic resonance imaging (MRI). She underwent an operation to remove the sinus tract together with the sac, and at the same time the tethered cord between the sac base and the distal end of the spinal cord was detached. The diagnosis of dermoid sinus and meningocele was confirmed histopathologically. These kinds of congenital pathologies in the cervical region may also predispose the patient to other diseases or symptoms. Herein, a case of meningocele associated with cervical dermoid sinus tract which presented with recurrent meningitis and a rare manifestation of mirror movement is discussed. Neurosurgeons should consider the possible coexistence of mirror movement and recurrent meningitis in the treatment of these types of congenital abnormalities.- - - - - - - - - - ranking = 6.7000081955532keywords = meningocele (Clic here for more details about this article) |
9/23. Anterior sacral meningocele with presacral cysts: report of a case.Anterior sacral meningocele is a rare anomaly most frequently presenting as a presacral mass. Since the first description in 1837, approximately 150 cases have been reported. The case presented is a 37-year-old female in whom an asymptomatic presacral mass was discovered during her first delivery. Because normal delivery was impossible, a cesarean section was performed. A year later, in a regional hospital a "cystic presacral tumor" was treated with biopsy and drainage. Four years later, she developed constipation caused by perineal compression for which she was admitted to our department in which two anterior presacral cysts were excised. The recovery was complicated with meningitis, which was successfully treated with antibiotics. Whenever a presacral mass is found, anterior sacral meningocele has to be a diagnostic consideration. The symptoms are usually related to the compression on rectum, bladder, and sacral nervous plexus. Rectal examination and radiography of the pelvis with the sacral bone showing the "scimitar sign" are the main diagnostic methods. myelography, computed tomography, and magnetic resonance imaging are the best methods for identifying the precise anatomy of sacral meningocele and for proper planning of the operation. Transvaginal or transrectal aspiration and drainage are not advised, because they may result in a lethal outcome caused by sepsis.- - - - - - - - - - ranking = 9.3800114737745keywords = meningocele (Clic here for more details about this article) |
10/23. The Currarino triad: neurosurgical considerations.OBJECTIVES: The Currarino triad, a relatively uncommon hereditary disorder, is often associated with tethered cord and anterior myelomeningocele. Little is known of the implications of these neuroanatomic malformations or of the neurosurgical attitude. The objective of this study is to identify the spinal cord and meningeal malformations associated with the Currarino triad and to discuss the risks and benefits of surgical intervention. methods: We analyzed the spinal cord malformations and the neurosurgical involvement with the Currarino triad by retrospective chart review. RESULTS: The Currarino triad neuroanatomic malformations were identified in five patients. The Currarino triad was associated with a tethered cord in three patients, a myelomeningocele in five patients, a syrinx in two patients, a fistula between the colon and spinal canal in two patients, and an Arnold-Chiari Type 1 malformation in one patient. CONCLUSION: Full spine imaging is required for all patients diagnosed with the Currarino triad. magnetic resonance imaging of the head should be performed in every patient with neuroanatomic anomalies. Surgery of an anterior myelomeningocele is not necessarily indicated, only in the rare case in which the space-occupying aspect is expected to cause constipation or problems during pregnancy or delivery. constipation directly after birth is seen in virtually all patients with the triad. Therefore, constipation cannot be used to diagnose a tethered cord syndrome nor indicate tethered cord release. Fistulas between the spinal canal and colon have to be operated on directly.- - - - - - - - - - ranking = 4.0200049173319keywords = meningocele (Clic here for more details about this article) |
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