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Ear, Nose, & Throat Journal Sep 2023Meningoencephalocele is an abnormal skull base protrusion of fluid, brain tissue, and meninges that can lead to nasal obstruction, meningitis, and Cerebrospinal Fluid...
Meningoencephalocele is an abnormal skull base protrusion of fluid, brain tissue, and meninges that can lead to nasal obstruction, meningitis, and Cerebrospinal Fluid (CSF) rhinorrhea. This condition can be managed operatively through an open craniotomy or a less invasive endoscopic approach. Here, we report a case of an 18-month-old female who presented with a meningoencephalocele that was part of the Sakoda complex, a rare neurosurgical phenomenon consisting of meningoencephalocele, agenesis of the corpus callosum, and cleft lip/palate. The patient was initially treated with the endoscopic transsphenoidal approach with subsequent open craniotomy.
Topics: Humans; Child; Female; Infant; Cleft Lip; Cleft Palate; Skull Base; Encephalocele; Meningocele; Endoscopy; Cerebrospinal Fluid Rhinorrhea
PubMed: 37574852
DOI: 10.1177/01455613231187760 -
Radiology Case Reports Sep 2023Meningoceles are a common radiological feature found in cases of idiopathic intracranial hypertension (IIH). Rarely, they can affect the facial canal within the petrous...
Meningoceles are a common radiological feature found in cases of idiopathic intracranial hypertension (IIH). Rarely, they can affect the facial canal within the petrous temporal bone, leading to symptoms such as facial nerve palsy, hearing loss or meningitis. This is the first case report that describes bilateral facial canal meningoceles involving the tympanic segment of the canal. Prominent Meckel's caves were also seen on MRI, a feature commonly associated with IIH.
PubMed: 37434617
DOI: 10.1016/j.radcr.2023.06.036 -
Journal of Neurosurgery. Case Lessons Jun 2023Posterior cervical meningoceles are rare in adults because most are surgically excised early in life. Such meningoceles in adults are mostly presented as a cystic mass...
BACKGROUND
Posterior cervical meningoceles are rare in adults because most are surgically excised early in life. Such meningoceles in adults are mostly presented as a cystic mass and their presentation as a solid mass is very rare.
OBSERVATIONS
An asymptomatic adult with cervical meningocele presented as a congenital midline skin covered solid mass in the posterior aspect of the neck is presented. Neuroradiological surveys showed attachment of the mass to intradural spinal cord. With diagnosis of a cervical meningocele, after excision of the solid sac, the stalk extending from the core of the mass to the dura was isolated. This was followed by intradural spinal cord detethering. The mass was compatible with rudimentary meningocele in pathology.
LESSONS
Neglected cervical meningocele is quite rare in adults. Surgical removal of the mass in adults is usually for cosmetic reasons rather than neurological impairment. However, surgical removal of the mass without intradural cord detethering is not sufficient. In such cases, late onset quadriparesis may be appear due to the spinal cord tethering scenario.
PubMed: 37310698
DOI: 10.3171/CASE23152 -
Frontiers in Veterinary Science 2023Two boxer dogs from the same litter were presented at 3 months of age for urinary and fecal incontinence. Both dogs had an abnormal tail consisting of a small stump, an...
Two boxer dogs from the same litter were presented at 3 months of age for urinary and fecal incontinence. Both dogs had an abnormal tail consisting of a small stump, an atonic anal sphincter, and absent perineal reflex and sensation. Neurological evaluation was indicative of a lesion of the cauda equina or sacral spinal cord. Radiology and CT scan of the spine displayed similar findings in the two dogs that were indicative of sacral agenesis. Indeed, they had 6 lumbar vertebrae followed by a lumbosacral transitional vertebra, lacking a complete spinous process, and a hypoplastic vertebra carrying 2 hypoplastic sacral transverse processes as the only remnant of the sacral bone. Caudal vertebrae were absent in one of the dogs. On MRI, one dog had a dural sac occupying the entire spinal canal and ending in a subfascial fat structure. In the other dog, the dural sac finished in an extracanalar, subfascial, well-defined cystic structure, communicating with the subarachnoid space, and consistent with a meningocele. Sacral agenesis-that is the partial or complete absence of the sacral bones-is a neural tube defect occasionally reported in humans with spina bifida occulta. Sacral agenesis has been described in human and veterinary medicine in association with conditions such as caudal regression syndrome, perosomus elumbis, and Currarino syndrome. These neural tube defects are caused by genetic and/or environmental factors. Despite thorough genetic investigation, no candidate variants in genes with known functional impact on bone development or sacral development could be found in the affected dogs. To the best of the authors' knowledge, this is the first report describing similar sacral agenesis in two related boxer dogs.
PubMed: 37303726
DOI: 10.3389/fvets.2023.1201484 -
Deutsches Arzteblatt International Mar 2023
Topics: Humans; Intracranial Hypotension; Meningocele
PubMed: 37222037
DOI: 10.3238/arztebl.m2022.0370 -
JNMA; Journal of the Nepal Medical... Apr 2023Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defects complex is a rare malformation complex that includes omphalocele, cloacal exstrophy, imperforate...
UNLABELLED
Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defects complex is a rare malformation complex that includes omphalocele, cloacal exstrophy, imperforate anus and spinal defects with the incidence of 1 in 200,000 to 400,000 pregnancies and is even rarer in twin gestation. The etiology of this complex is still unclear. Most cases are sporadic. Prenatal screening must be done for diagnosis and appropriate multidisciplinary management of cases. In severe cases, termination of pregnancy is considered. We present a 4-day first twin child with underdeveloped ambiguous genitalia delivered via emergency lower section cesarean section at 32+3 weeks of gestation with giant liver containing omphalocele, cloacal exstrophy, imperforate anus and meningocele with severe pulmonary artery hypertension and non-visualization of right kidney and ureter, absence of uterus, fallopian tubes and right ovary. Separation and repair of the cecum and bladder were done. The ladd procedure was performed. Ileostomy was created and single-stage repair of the abdominal wall was done.
KEYWORDS
anorectal malformations; bladder exstrophy; case reports; neural tube defects; umbilicus.
Topics: Child; Animals; Humans; Pregnancy; Female; Anus, Imperforate; Hernia, Umbilical; Cloaca; Cesarean Section; Abnormalities, Multiple; Bladder Exstrophy
PubMed: 37208890
DOI: 10.31729/jnma.8048 -
International Journal of Surgery Case... Jun 2023Injury to the maxillofacial region is of great importance due to the highly sensitive area, and the vital structures it carries. Special surgical wounding techniques...
INTRODUCTION AND IMPORTANCE
Injury to the maxillofacial region is of great importance due to the highly sensitive area, and the vital structures it carries. Special surgical wounding techniques must be used due to the significant tissue destruction. We report a unique case of a ballistic blast injury in a pregnant woman in a civilian setting.
CASE PRESENTATION
A 35-year-old pregnant female, in the third trimester, presented at our hospital after ballistic ocular and maxillofacial injuries. Due to the complex nature of her injury, a multi-disciplinary team consisting of otolaryngologists, neurosurgeons, ophthalmologists, and radiologists was formed to manage the patient. She was managed by performing an evisceration followed by an enucleation and a spherical implant, then underwent mandibulo-maxillary fixation due to a foreign body medial to the left ramus. This initial management plan proved to be effective until two (2) years later, she presented with new onset meningocele and active CSF rhinorrhea and meningitis, due to a left anterior skull base defect. The patient was then managed by reconstructive orbital and ethmoidal roof surgery. In addition, her pregnancy had favorable outcomes after an uneventful delivery.
CLINICAL DISCUSSION
Civilian setting injuries are specifically sensitive due to the lack of proper protection, such as in this case. This patient, a pregnant victim of a ballistic blast injury, was managed successfully by a multidisciplinary team through multiple reconstructive surgeries yet presented with a late life-threatening complication.
CONCLUSION
Long-term follow-up for such complex cases is recommended due to the possibility of late complications, despite adequate surgical management.
PubMed: 37196475
DOI: 10.1016/j.ijscr.2023.108210 -
Cureus Mar 2023Currarino syndrome or Currarino triad is a complex condition consisting of congenital anomalies. The triad consists of anterior sacral mass (meningocele, teratoma or...
Currarino syndrome or Currarino triad is a complex condition consisting of congenital anomalies. The triad consists of anterior sacral mass (meningocele, teratoma or dermoid/epidermoid cyst), sacral bone defect (hypoplasia, agenesis ), anorectal malformation/congenital anorectal stenosis. This condition is named after Dr Guido Currarino, an Italian-American paediatric radiologist, who first described it in 1975. This needs a multidisciplinary treatment approach. We describe a case of successfully managed young adult with Currarino syndrome. The latest artificial intelligence tool, Chat Generative Pre-Trained Transformer (ChatGPT), helped to write this case report.
PubMed: 37090396
DOI: 10.7759/cureus.36497