Duraplasty is one of the most common neurosurgical procedures which complications include iatrogenic pseudomeningocele, which is common, but ossification of pseudomeningocele following cranial surgery is a rare event. We present a case of a 2-year-old male patient who came to our hospital with a huge bulge in his head and weakness in the right arm and leg. He had a history of sagittal craniosynostosis with a postoperative cranioplasty complication of left parital pseudomeningocele. He underwent a duraplasty, but the bulge recurred with failed cerebrospinal fluid aspiration and external ventricular drain, changing in size periodically. Computed tomography showed that the bulge was a median and left paramedian parital encephalocele, so encephalocele with ossification was diagnosed and a cranioplasty was done. This case highlights that iatrogenic encephaloceles with ossification can develop after duraplasty repair in the parital region. Also, if a postoperative pseudomeningocele changes in size or consistency, clinicians should look for ossification.
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http://dx.doi.org/10.1093/jscr/rjae442 | DOI Listing |
PLoS One
January 2025
Department of Convergence of Healthcare and Medicine, Ajou University Graduate School of Medicine, Suwon, South Korea.
Brain herniation can be a life-threatening condition, resulting in poor prognosis and higher fatality rates. We examined whether quantitative characteristics of sequential pupillary light reflex (PLR) could serve as biomarkers for identifying brain herniation in fatal acute stroke cases with anterior circulation involvement admitted to neurological intensive care unit (Neuro-ICU). Automatic pupillometer assessed PLR automatically every 4-6 hours, measuring eight specific features: NPi (Neurological pupil index) score, initial resting and constriction pupil size, constriction change, constriction velocity, constriction latency, and dilation velocity.
View Article and Find Full Text PDFAm J Otolaryngol
December 2024
Otolaryngology-Head and Neck Surgery Department, "San Bortolo" Hospital, Vicenza, Italy.
Congenital meningoencephaloceles of the anterior skull base (ASB) are rare lesions that become evident during childhood and, if not properly diagnosed and treated, can be associated with severe complications. In the past, encephaloceles were treated exclusively with open surgical approaches, which, however, are associated with high complication rates. Recent years have seen the large-scale introduction of transnasal endoscopic approaches to the skull base, and several Authors suggest that endoscopic resection and repair in cases of meningoencephalocele may be the treatment of first choice, being associated with lower complication rates and reduced operative time compared with open procedures.
View Article and Find Full Text PDFSurg Neurol Int
October 2024
Department of Neurological Surgery, Childrens Hospital of Orange County, Orange, California, United States.
Background: Otitis media (OM) can uncommonly lead to intracranial complications. Epidural abscesses represent a large proportion of cases; however, literature regarding the optimal surgical management of otogenic epidural abscesses is sparse. Favorably located epidural abscesses may be amenable to drainage through a transmastoid approach because the tegmen mastoideum lies immediately inferior to the middle cranial fossa (MCF).
View Article and Find Full Text PDFOtol Neurotol
January 2025
Eaton-Peabody Laboratories, Massachusetts Eye and Ear (MEE), Department of Otolaryngology, Harvard Medical School, Boston, MA.
Objective: To review the management of meningitis, large lateral skull base defect, and meningoencephalocele following pediatric cochlear implant (CI) surgery.
Study Design: Case report.
Methods: Patient demographics, medical and surgical history, computed tomography (CT).
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