ABSTRACT
Acquired non-traumatic transethmoidal encephaloceles are very infrequent lesions that are generally caused by a tumor or hydrocephalus. As far as we know, there is no reported case of encephalocele after CSF diversion in the literature. We present a 25-year-old woman with hydrocephalus due to aquiductal stenosis who was treated with endoscopic third ventriculostomy. Nine months later, she had developed rhinorrhea and on imaging she had a transethmoidal encephalocele. She underwent endonasal endoscopic repair of the defect and removal of herniated parenchyma. CSF diversion to parasellar cisterns is not a known iatrogenic cause of basal encephalocele and is not noted elsewhere as a complication of third ventriculostomy. However, as third ventriculostomy is performed usually for intracranial hypertension treatment and intracranial hypertension itself is a known but rare cause of lacunar skull defect and encephalocele, this co-incidence may occur.
Subject(s)
Cerebral Aqueduct/pathology , Encephalocele/etiology , Ethmoid Sinus/pathology , Intracranial Hypertension/complications , Intracranial Hypertension/surgery , Postoperative Complications/etiology , Adult , Cerebrospinal Fluid Leak , Cerebrospinal Fluid Rhinorrhea/etiology , Constriction, Pathologic , Female , Humans , Hydrocephalus/surgery , Third Ventricle/surgery , Treatment Outcome , VentriculostomyABSTRACT
We report the safety and efficacy of bilateral foraminoplasty of Monro in a patient with partial occlusion of right Monro and complete occlusion of the left one. A 38-year-old man who underwent a ventriculoperitoneal shunt three years ago, and shunt revision surgery twice, presented with hydrocephalus, and was referred to us because of continuing complaints of headaches, nausea and vomiting. The primary surgical treatment of the patient was bilateral endoscopic Monro foraminoplasty. Then, the patient did not need a ventriculoperitoneal shunt, and hydrocephalus was resolved. Bilateral monroplasty in a single-session surgery can be the treatment of choice, instead of microsurgically open reconstruction of the foramen of Monro. The procedure can be less invasive, and it avoids ventriculoperitoneal shunting.
Subject(s)
Cerebral Ventricles/surgery , Hydrocephalus/surgery , Neuroendoscopy/methods , Postoperative Complications/surgery , Ventriculoperitoneal Shunt/methods , Adult , Humans , Male , Plastic Surgery Procedures/methods , ReoperationABSTRACT
The authors report an unusual case of intradural epidermoid tumour in a 19-year-old girl presenting with refractory complex partial seizures including auditory hallucinations, and memory dysfunction. A complete resection was carried out sparing the hippocampus resulting in seizure freedom.
