ABSTRACT
Intrasphenoidal encephalocoeles are acquired or congenital herniations of meninges and brain parenchyma through a structural sphenoid bone defect. Acquired causes are most common, either iatrogenic, post-traumatic, or spontaneous. However, defects in the lateral wall of the sphenoid sinus are uncommon and cephalocoeles through them relatively underexplored in current literature, warranting dedicated attention to unravel their complexities. Congenital causes such as persistence of Sternberg's canal, which can lead to lateral cephalocoeles, is a rare entity, seen in two of the presented cases, based on the location of the defect with respect to the line connecting the foramen rotundum and the vidian canal (VR line). Three cases of intrasphenoidal cephalocoeles are presented; two patients presented with watery nasal discharge without prior trauma or surgery and the third case was incidentally detected in an elderly patient with intraparenchymal haemorrhage. Imaging with CT cisternography and brain MR were performed to ascertain the exact location of the leak and confirm the presence of herniated brain tissue via the defects. Patients were evaluated by otolaryngology for transnasal endoscopic repair, which was deemed unfeasible, and referred to neurosurgery for transcranial duroplasty. Contribution: These cases provide crucial insights into the aetiology of lateral intrasphenoidal cephalocoeles, offering a practical system to classify cerebrospinal fluid (CSF) leaks based on the bony defect location. The three illustrative cases and emphasis on advanced imaging modalities refine the knowledge of their aetiology, clinical presentation and management, which hold direct clinical relevance for accurate diagnosis and tailored management of these rare anomalies.
ABSTRACT
Extra-abdominal fibromatosis is an uncommon, benign locally aggressive fibrous soft-tissue tumor that usually occurs in the shoulders, chest wall, back, thigh, and head and neck affecting the young adult population. It is commonly located in the subcutaneous tissue and may infiltrate the adjacent skeletal muscles. We hereby report a rare case of a large extra-abdominal fibromatosis of the leg and foot in a 38-year-old woman. The patient presented with a large voluminous lesion clinically and on imaging, which was difficult to diagnose. Magnetic resonance imaging (MRI) was very helpful in diagnosing the lesion. It revealed a large relatively well-defined, lobulated hypointense mass in the posterior compartment of the leg with extension into the lower thigh and foot with local infiltration into the gastrocnemius and soleus muscles. An incisional biopsy was performed, and the mass was diagnosed on pathological examination as a spindle-shaped fibroblast proliferation suggesting extra-abdominal fibromatosis.
ABSTRACT
Bowel injury secondary to blunt trauma abdomen is a commonly encountered entity. However, small bowel obstruction secondary to traumatic incarceration of bowel loops between two translated vertebras in a case of road traffic accident is seldom reported. We report a case of small bowel obstruction in a patient who had suffered spondyloptosis at the L1-L2 level after a motor vehicle accident. We also discuss the diagnostic work up and interventions done to manage the patient. The report also reviews pertinent published literature on the incarceration of the bowel associated with vertebral fractures.
ABSTRACT
Osteomas of paranasal sinuses are common benign tumors and are diagnosed incidentally. However, osteomas complicated by pneumocephalus with air fluid level presenting with progressive hemiparesis is rare. Here, we present a case report of a 22-year-old male who presented with left-sided progressive hemiparesis with history of generalized headache since 2 years.
