Cases reported "Meningocele"

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1/46. 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.
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keywords = skull
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2/46. 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.
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ranking = 0.28571428571429
keywords = skull
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3/46. dandy-walker syndrome associated with occipital meningocele and spinal lipoma--case report.

    A neonate presented with dandy-walker syndrome associated with occipital meningocele and spinal lipoma, manifesting as soft masses on the skull and lumbosacral regions. magnetic resonance imaging demonstrated a large posterior fossa cyst between the fourth ventricle and occipital meningocele, but the aqueduct was patent and there was no sign of hydrocephalus. A cyst-peritoneal shunt was emplaced at the age of 8 days followed by partial removal of the spinal lipoma and untethering of the cord at the 3 months. Follow-up examination of age 3 years found almost normal development, although the cyst still persisted.
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ranking = 0.14285714285714
keywords = skull
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4/46. Lumbosacral nerve root avulsion: report of a case and review of the literature.

    The 14th myelographically demonstrated case of lumbosacral nerve root avulsion is presented with a summary of the previously reported cases. In most cases lumbosacral nerve root avulsion is associated with pelvic fractures and sacroiliac dislocation, which cause a stretching force to be applied to the nerves of the lumbar and sacral plexuses, and in turn to the nerve roots intradurally. This force causes nerve root avulsion in the intradural course of the nerve root. The myelographic defect is a pseudomeningocele or diverticulum-like outpouching created by the tearing of the arachnoid covering of the nerve roots. myelography clearly indicates nerve root avulsion and surgical exploration is not indicated.
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ranking = 0.027943257832849
keywords = fracture
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5/46. An unusual pterygopalatine meningocele associated with neurofibromatosis type 1. Case report.

    The authors describe an unusual meningocele of the lateral wall of the cavernous sinus and the anterior skull base in a young patient with typical stigmata of neurofibromatosis Type 1 (NF1). This lesion was discovered during evaluation for recurrent meningitis. It represented an anterior continuation of Meckel's cave into a large cerebrospinal fluid space within the lateral wall of the cavernous sinus, extending extracranially through an enlarged superior orbital fissure into the pterygopalatine fossa adjacent to the nasal cavity. It was successfully obliterated, via an intradural middle fossa approach, with fat packing and fenestration into the subarachnoid space. This meningocele most likely represents a variant of cranial nerve dural ectasia occasionally seen in individuals with NF1. It has as its basis the same mesodermal defect responsible for the more common sphenoid wing dysplasia and spinal dural ectasias identified with this condition. Involvement of the trigeminal nerve with expansion of the lateral wall of cavernous sinus has not been reported previously. The authors surmise, however, that it may be present in some cases of orbital meningocele associated with sphenoid wing dysplasia.
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ranking = 0.14285714285714
keywords = skull
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6/46. Occipito-clival intradiploic meningocoele following skull fracture in infancy.

    An adolescent presented with an intradiploic meningocoele 11 years after an occipital skull fracture. Surgical treatment consisted initially of cranioplasty, but the lesion then progressed to involve much of the skull base, requiring cystoperitoneal shunt insertion. The pathogenesis and treatment of post-traumatic intradiploic meningocoele is discussed.
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ranking = 9.9868102210091
keywords = skull fracture, skull, fracture
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7/46. Post-traumatic lumbar nerve root avulsion.

    Lumbar nerve root avulsion is a rarely seen clinical entity that may complicate major trauma. The majority of previously reported cases have associated pelvic or lumbar vertebral fractures. Two cases of traumatic pseudomeningoceles at the lumbar level with associated avulsions of the lumbar nerve roots are presented. Both patients were involved in high velocity motor vehicle accidents. Case 1 had associated pelvic fractures but no spinal fractures and, interestingly, case 2 had no fractures of the spine or pelvis. The value of MRI in making the diagnosis is demonstrated.
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ranking = 0.1117730313314
keywords = fracture
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8/46. Sequestrated meningocele of the scalp.

    A case of occipital sequestrated (rudimentary) meningocele in a 2-year-old girl is presented. The swelling was noticed at birth and did not grow over time. The skull radiograph showed no bone defect and ultrasound and computed tomography examinations demonstrated cystic mass with no connection to dura. The aim of this report is to draw the attention of radiology literature readers to this entity and to elaborate on the role of imaging in the preoperative assessment of such cases. The relation of sequestrated meningocele to the other conditions with ectopic meningeal tissue in the scalp is addressed.
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ranking = 0.14285714285714
keywords = skull
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9/46. Management of multiple spontaneous nasal meningoencephaloceles.

    OBJECTIVES/HYPOTHESIS: Multiple spontaneous nasal meningoencephaloceles in the same patient are rare lesions. Although many skull base defects occur after prior trauma or surgery, otolaryngologists must be aware of the potential for spontaneous encephaloceles. We present our experience with this unusual condition and discuss its pathophysiology and unique management issues. STUDY DESIGN: Retrospective. methods: review of medical records, radiographic images, and cerebrospinal fluid pressures. RESULTS: We identified 5 patients with multiple, simultaneous, spontaneous encephaloceles: 4 patients with 2 encephaloceles and 1 patient with 3 encephaloceles (11 in all). Locations of the 11 encephaloceles were sphenoid lateral recess (6), frontal sinus with supraorbital ethmoid extension (2), ethmoid roof (1), frontal sinus (1), and central sphenoid (1). Three patients had bilateral sphenoid lateral recess encephaloceles, accounting for all six in that location. All four patients with available radiographic studies demonstrated empty sella turcica. Surgical approaches included endoscopic transpterygoid approach to the lateral sphenoid recess (3), endoscopic approach to ethmoid and central sphenoid (3), and osteoplastic flap with frontal sinus obliteration (2). We had 100% success at latest endoscopic follow-up (mean period, 17 mo). Three patients had postoperative lumbar punctures with mean cerebrospinal fluid pressure of 28.3 cm water (range, 19-34 cm; normal range, 0-15 cm). Conclusions: Multiple spontaneous encephaloceles can be managed safely and successfully using endoscopic and extracranial approaches. A high index of suspicion for this diagnosis must be maintained, especially in patients with radiographic evidence of laterally pneumatized sphenoid sinuses or empty sella. Spontaneous encephaloceles and cerebrospinal fluid leaks represent a form of intracranial hypertension.
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ranking = 0.14285714285714
keywords = skull
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10/46. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child.

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed.
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ranking = 0.027943257832849
keywords = fracture
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