Idiopathic diffuse erosion of the skull base presenting as cerebrospinal fluid rhinorrhoea

1998 ◽  
Vol 112 (7) ◽  
pp. 679-681 ◽  
Author(s):  
P. J. Conboy ◽  
I. J. M. Johnson ◽  
T. Jaspan ◽  
N. S. Jones

AbstractWe present an unusual case of generalized erosion of the skull base. We have not found a similar case reported in the world literature. The presenting symptom was spontaneous cerebrospinal fluid (CSF) rhinorrhoea which arose from a bony defect associated with herniation of the right temporal lobe into the sphenoid sinus. We discuss the management of such a case including imaging of the skull base and the endoscopic repair of the bony defect.

2006 ◽  
Vol 43 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Masaki Fujioka ◽  
Isao Tasaki ◽  
Riko Nakayama ◽  
Aya Yakabe ◽  
Hiroshi Baba ◽  
...  

Objective and Patient Both nasal cerebral heterotopia and encephalocele are rare congenital benign masses of neurogenic origin caused by an embryonic developmental abnormality. It is generally accepted that nasal heterotopia is a sequelae to encephalocele. This report presents an unusual case of nasal cerebral heterotopia and encephalocele arising in the same patient. The patient had a firm, solid mass measuring 1.5 × 1.0 cm on the bridge of the nose covered with normal skin and another mass in the nasal cavity obstructing the right nasal cavity. Computed tomography (CT) demonstrated that the nasal bone separated these masses. CT also showed a bony defect at the skull base. Surgery consisted of dividing the encephalocele and closure of the skull base fistulae, along with nasal subcutaneous mass enucleation. Results Intraoperative examination indicated the existence of a pit on the nasal bone where the pedicle of the nasal subcutaneous mass connected. Microscopic examination of the nasal cavity mass demonstrated meningoencephalocele, and examination of the nasal subcutaneous mass demonstrated nasal cerebral heterotopia, which was confirmed by immunohistochemical staining. After 10 months, complete removal of the subcutaneous nasal mass was recognized and there was no evidence of recurrence. Conclusion Findings in this case suggest that the nasal cerebral heterotopias will result from encephalocele.


2021 ◽  
pp. 014556132110185
Author(s):  
Michela Borrelli ◽  
Kristen A. Echanique ◽  
Jeffrey Koempel ◽  
Elisabeth H. Ference

Penetrating transorbital injury with skull base involvement is a rare occurrence from a crayon. We report a case of a 2-year-old male who sustained a penetrating crayon injury through the right orbit and lamina papyracea into the posterior ethmoid sinus complicated by cerebrospinal fluid leak. There have been no other reported cases of this type of injury by a crayon.


Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 989-991 ◽  
Author(s):  
Bradley J. Bartholomew ◽  
Charla Poole ◽  
Emilio C. Tayag

Abstract OBJECTIVE AND IMPORTANCE Penetrating injuries of the cranium and spine are frequent to the civilian neurosurgical practice. Although a variety of unusual objects have been reported, to our knowledge, there has never been a craniocerebral or spinal injury caused by a fish. An unusual case of transoral penetration of the foramen magnum by a billed fish is described. The history, radiographic studies, and treatment are presented. CLINICAL PRESENTATION A fisherman struck by a jumping fish initially presented with severe neck pain and stiffness, bleeding from the mouth, and a laceration in the right posterior pharynx. A computed tomographic scan of the cervical spine revealed a wedge-shaped, hyperdense object extending from the posterior pharynx into the spinal canal between the atlas and the occiput. Because of the time factor involved, the fisherman was brought directly to surgery for transoral removal of the object. INTERVENTION The patient was placed under general anesthesia, and with a tonsillar retractor, a kipner, and hand-held retractors, the object was visualized and identified as a fish bill. Further dissection above the anterior aspect of the atlas permitted removal of the object by means of a grabber from an arthroscopic set. No expression of cerebrospinal fluid was noted, and a Penrose drain was placed. CONCLUSION The patient was treated under the assumption that penetrating foreign objects in continuity with the cerebrospinal fluid space and the outside environment should be removed as soon as possible. The patient was provided appropriate antibiotics to treat potential infection of normal pharyngeal flora and organisms unique to the marine environment. The patient recovered and did not experience any residual neurological deficit.


2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Marcos Vilca ◽  
◽  
Carlos Palacios ◽  
Sofía Rosas ◽  
Ermitaño Bautista ◽  
...  

Introduction: Pneumocephalus is mainly associated with traumatic injuries, being a rare complication but with high mortality rates; it behaves like a space-occupying lesion and increases intracranial pressure. The symptoms are not specific, but in the event of trauma it is necessary to suspect this entity to carry out a timely diagnosis and treatment, since being the product of the skull base fracture it can cause communication with the outside, and the appearance of cerebrospinal fluid (CSF) leak. Clinical Case: a 38-year-old male patient who suffers trauma from a pyrotechnic explosion near his right ear, when handling a pyrotechnic object (whistle) during the New Year, presenting severe pain, slight bleeding in the right ear, feeling faint and holocranial headache that increased in a standing position; likewise, he presents high-flow aqueous secretion (CSF) from the right ear. Brain and skull base tomography (CT) showed air in the intracranial cavity, fracture of the skull base, and the ossicles of the right middle ear. Conservative management was performed using rest and lumbar drainage, presenting a satisfactory evolution. Conclusion: Pneumocephalus is a frequent and expected complication of trauma with a skull base fracture. Its early and timely diagnosis using skull base CT is essential to define therapeutic measures. Accidents due to the misuse of pyrotechnics continue to be a relevant problem in our country. Knowing and disseminating its consequences can help raise awareness in the population. Keywords: Pneumocephalus, Skull Base, Intracranial Pressure, Cerebrospinal Fluid Leak. (Source: MeSH NLM)


2010 ◽  
Vol 124 (12) ◽  
pp. 1294-1297 ◽  
Author(s):  
P Thulasi Das ◽  
D Balasubramanian

AbstractObjective:To present our experience in managing cerebrospinal fluid rhinorrhoea using the cartilage inlay (underlay) technique to repair skull base defects larger than 4 mm.Study design:Retrospective study involving patients presenting with cerebrospinal fluid rhinorrhoea between 1994 and 2008.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patients' medical records were reviewed and analysed.Results:A total of 62 patients were operated upon using a cartilage inlay technique to repair bony skull base defects ranging in size from 4 to 20 mm (widest diameter). Of these 62 patients, 16 constituted revisions of earlier procedures undertaken elsewhere. The success rate of the technique was 100 per cent. Patient follow up ranged from six months to 16 years, with a median follow up of 15 months. Three patients had minor post-operative sinus infections; no serious complications were encountered.Conclusion:Extradural cartilage inlay appears to be an effective technique in the management of cerebrospinal fluid rhinorrhoea, especially for large defects and revision procedures. To our knowledge, the described patients represent the largest reported series of cerebrospinal fluid rhinorrhoea cases managed using the cartilage inlay technique. We believe that the crucial factors in our high success rate for cerebrospinal fluid fistula repair are: precise identification of the bony defect; meticulous preparation of the graft bed; careful elevation of the dura; judicious use of just enough graft tissue; and adequate graft support.


2011 ◽  
Vol 51 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Mika KOMATSU ◽  
Fuminari KOMATSU ◽  
Luigi M. CAVALLO ◽  
Domenico SOLARI ◽  
Vita STAGNO ◽  
...  

2008 ◽  
Vol 122 (8) ◽  
Author(s):  
Y S Yang ◽  
K H Hong

AbstractObjective:We report an extremely rare case of thyroid hemiagenesis with ectopic lingual thyroid.Method:Case report and review of the world literature concerning thyroid hemiagenesis with ectopic lingual thyroid and heredity.Results:Ectopic thyroid is an uncommon embryological aberration characterised by the presence of thyroid tissue in a site other than its usual, pretracheal location. The lingual thyroid is the most common manifestation of benign ectopic thyroid tissue, but is still a rare clinical entity. Thyroid hemiagenesis is also a very rare abnormality, in which one thyroid lobe fails to develop. We report a case of left thyroid hemiagenesis and goitre in the right lobe in a 26-year-old woman with an ectopic lingual thyroid.Conclusion:To our knowledge, this is the first report in the world literature of thyroid hemiagenesis with ectopic lingual thyroid.


Author(s):  
Dr. K. Mini

The Vedas are one of the oldest manuscripts in the world literature. The word Veda is derived from the Sanskrit root ‘vid’ which means knowledge, but it could be attributed as a bundle of knowledge of the Vedic period. All the Indian chronicles and myths extol the Vedas. There is not even a single mantra anywhere in the sacred text repudiating anyone the right to become versed in Vedas but the authority to study and teach the Vedas abounding with knowledge, has been interpreted as the right of a monopolized community gradually. Prominent social reformers like Dayananda Saraswati and Swami Vivekananda who visited India in the late 19th century argued that everyone has the right to study the Vedas. Meanwhile, Chattambi Swami wrote Vedadhikara Nirupanam, proclaiming that the right to study Veda belongs to everyone in Kerala. In this book, Chattambi Swami analyses extensively the question of who is qualified to study the Vedas and has explicitly established that everyone who has the desire to study the Vedas and the customs in rapport with it are eligible for the study. The dissension created by this work was tremendous during the time when the elite castes and scholars of the society strongly believed and argued that only Brahmins had the dominion to study the Vedas. Vyaptheshcha Samajasam is elaborated in the Brahma Sutras as follows. Para brahma swaroopi, Parameswaran (Lord Shiva) is omnipresent, omnipotent, omniscient and absolute. On account of this, it is equitable to say that even if there is a disparity in the name or context of the theosophical form of knowledge, the objective serves as the same. The purpose of all techniques is to illustrate the essence of God in copious ways. They all have similarities in it. Therefore every theosophy is analogous. After reflecting the Vedic forms and significance of the Vedas, Chattambi Swami encompasses the principles of Shruti(what is heard), Yukti(logic) and Anubhavam (experience) and depicts his own perceptions. Similarly, Swami meticulously discusses who is a Brahmin. For instance, Swami examines whether any of these qualities like pure knowledge, birth, noble action and self knowledge make a person a Brahmin or a combination of all these. From this discussion it is implicit that a Brahmin is only one who has wisdom and associated noble deeds. The dogma that the Shudrascannot be educated ‘nasthrishudrau vedamathiyatham’, this verse is neither a Veda nor a Smriti, it is just a sutra (aphorism).It is not accepted or studied anywhere in Shruti (what is heard) Smriti (what is recollected) mythological texts. Therefore, it does not have to be accepted as a doctrine. The verse means that women and Shudras need not have to study but it cannot be interpreted that they are incapable to learn. Even if it is argued that Shudras (lowest ranked of the four varnas of Hindu caste system) have no authority to study the Puranas, many of the authors of the Puranas are Shudras. The veracity of the matter cannot be denied. Most people know that the author of the Suta Samhita is also a Shudra. Ergo, the eminence of that book cannot be deemed as inferior. Parasaran, the son of Odakkari, and Vyasa, the son of Mukuvathi (fisherwoman) compiled the Vedas and were also Brahmins.


2020 ◽  
Author(s):  
Xiaofei Liu ◽  
Ping Chen ◽  
Bing Wang

Abstract Background:Dural and bony defects mostly occur in the same position in the cerebrospinal fluid(CSF)rhinorrhea of anterior cranial base fractures,and a few cases of delayed CSF leakage after repair are also reported.Case presentation:We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation.A minimally invasive approach through an eyebrow incision was performed for reoperation,it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions:This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual,and appropriate approach should be adopted to repair the dural and bony defects , the transeyebrow approach is a good choice.


2020 ◽  
Vol 9 (02) ◽  
pp. 115-121
Author(s):  
Alexandrina Nikova ◽  
Varvara Chatzipaulou ◽  
Belkis Malkots ◽  
Reichan Molla Mustafa ◽  
Christina Valsamidou ◽  
...  

Abstract Objective Hemivertebra (HV) is a congenital defect of the formation of the spinal vertebra, which can result in scoliosis or kyphosis along with the related symptomatology of spine deformity. More often than not, it is linked to other abnormalities and requires attention. Its management is surgical and it is of great importance for the physician to choose the right approach at the right time, due to its deteriorative prognosis. Methods Due to the interest of the subject, the authors investigated the world literature between 1990 and 2018 and found 45 articles, reporting thoracic, thoracolumbar, and lumbar HV in children and its postsurgical outcome, aiming to show whether the approaches are equal in terms of the final outcome. Results The chosen surgical method depends much on the level of the pathology. Despite this fact, after analyzing the included data, we found that the surgical techniques are unequal with regard to the purpose of achieving improvement. Age, caudal and cranial curves, segmental kyphosis, and scoliosis are factors playing a major role in this. Conclusion If not treated, HV leads to deterioration and dysfunction. The most optimal result, however, is achieved only when the surgical approach is applied according to age and rest of the accompanying factors, which should be considered in future management planning.


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