Giant Arachnoid Cyst Associated with an Orbital Meningocele: A Case Report and Cystoperitoneal Shunt Management

2021 ◽  
pp. 1-6
Author(s):  
Mohamed Khoulali ◽  
Noureddine Oulali ◽  
Nabil Raouzi ◽  
Fayçal Moufid
Keyword(s):  
Case Report ◽  
Mass Effect ◽  
Bony Defect ◽  
Older Children ◽  
Orbital Roof ◽  
Ophthalmic Manifestations ◽  
Adjacent Structures ◽  
Cystoperitoneal Shunting ◽  
The Right ◽  
Inner Region

<b><i>Introduction:</i></b> Intracranial arachnoid cysts (ACs) are space-occupying lesions that typically remain stable in size and clinically silent over time. <b><i>Case Report:</i></b> We describe an unusual pediatric case of enlarged AC impressive by its compressive phenomena. An 11-month-old girl presented with remarkable macrocephaly associated with a cystic orbital tumor. CT scan and MRI studies revealed a large intracranial ACs extending in the orbit with an orbital meningocele (OM). The intracranial cyst did communicate with the orbital one into a bony defect in the right inner region of the orbital roof and represses the globe outward. A cystoperitoneal shunting procedure was performed to remove the mass effect as soon as possible and facilitate normal development. <b><i>Discussion/Conclusion:</i></b> Cysts in infants younger than 1 year of age are remarkably different from those in older children and adults in terms of cyst localization and enlargement. Classically described complications result from compression of adjacent structures and include focal neurologic involvement, headaches and seizures and developmental deficits, or macrocephaly in younger children. There are few cases of ACs with ophthalmic manifestations reported in the literature. The paucity of literature prompted us to analyze the case. To the best of our knowledge, an AC accompanying OM has not been reported. The pathogenesis and management of the case will be discussed.

Chronic, otogenic, epidural pneumatocoele with delayed mass effect: case report

2009 ◽  
Vol 124 (5) ◽  
pp. 552-556 ◽  
Author(s):  
F Barbieri ◽  
F Fiorino
Keyword(s):  
Case Report ◽  
Mass Effect ◽  
Sudden Onset ◽  
Middle Ear Pressure ◽  
Bone Powder ◽  
Risk Of Rupture ◽  
Intracranial Complications ◽  
Traumatic Origin ◽  
Anterior Fossa ◽  
The Right

AbstractIntroduction: Mastoid hyperpneumatisation predisposes to intracranial pneumatocoele development, due to the risk of rupture of the thin, bony walls. Intracranial pneumatocoele may be precipitated by even minor head trauma or an abrupt change in middle-ear pressure, with the potential risk of infectious or compressive intracranial complications.Case report: A 19-year-old man with mastoid hyperpneumatisation developed a chronic intracranial–epidural pneumatocoele of traumatic origin in the right parieto-occipital area, in contiguity with the posterior mastoid cells. Eighteen months later, after a common cold, the patient developed signs of intracranial hypertension, due to the pneumatocoele spreading to the right epidural anterior fossa. A large right mastoidectomy extended to the retrosigmoid cells was performed, and a watertight seal applied over a large retrosigmoid cell using bovine pericardium and a mixture of bone powder and fibrin glue.Results: The patient was discharged on post-operative day three with no symptoms. Ten days after surgery, computed tomography monitoring showed complete reabsorption of the pneumatocoele.Conclusion: In cases of chronic, otogenic, epidural pneumatocoele, the possibility of the sudden onset of serious complications suggests the need for early repair of the communication between the temporal bone and the intracranial compartments. Closure of the fistula using autogenic and/or allogenic materials is usually adequate to resolve the pneumatocoele.

Intracranial Cisternal Lipoma Associated with Cerebellar Cortical Dysplasia Diagnosed Using Dixon Technique: A Case Report and a Review of Literature

2021 ◽  
Vol 17 ◽  
Author(s):  
Minhee Hwang ◽  
Hyun Park ◽  
Hye Jin Baek ◽  
Kyeong Hwa Ryu ◽  
Eun Cho ◽  
...  
Keyword(s):  
Case Report ◽  
Brain Mri ◽  
Relevant Literature ◽  
Cortical Dysplasia ◽  
Cerebellar Hemisphere ◽  
Vertical Orientation ◽  
Water Separation ◽  
Intracranial Lipoma ◽  
Adjacent Structures ◽  
The Right

Background: Intracranial lipomas are sporadic congenital malformations. Previous studies have shown various brain anomalies related to intracranial lipomas, most of which are agenesis or dysgenesis of the adjacent structures. To the best of our knowledge, cortical dysplasia related to intracranial lipoma has yet to be reported. Case Report: We present a rare case of intracranial lipoma in the quadrigeminal and superior cerebellar cisterns with combined cerebellar cortical dysplasia. A 43-year-old female underwent brain MRI to identify possible causes of headache. We made a confident diagnosis based on MR findings using Dixon technique, which is a fat-water separation method based on chemical shift. We also identified unique combined abnormalities of the right cerebellar hemisphere near the cisternal lipoma that showed an abnormal vertical orientation of the cerebellar folia and disorganized parenchymal pattern. Conclusion: This case exhibits the rareness of the intracranial lipoma related cerebellar cortical dysplasia by reviewing relevant literature and also highlights the usefulness of Dixon techniques in daily clinical practice.

scholarly journals Flow diversion and microvascular plug occlusion for the treatment of a complex unruptured basilar/superior cerebellar artery aneurysm: case report

2019 ◽  
Vol 130 (6) ◽  
pp. 1978-1983 ◽  
Author(s):  
Jan-Karl Burkhardt ◽  
Howard A. Riina ◽  
Omar Tanweer ◽  
Peyman Shirani ◽  
Eytan Raz ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Options ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Superior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Endovascular Approach ◽  
Aneurysm Occlusion ◽  
The Right

The authors present the unusual case of a complex unruptured basilar artery terminus (BAT) aneurysm in a 42-year-old symptomatic female patient presenting with symptoms of mass effect. Due to the fusiform incorporation of both the BAT and left superior cerebellar artery (SCA) origin, simple surgical or endovascular treatment options were not feasible in this case. A 2-staged (combined deconstructive/reconstructive) procedure was successfully performed: first occluding the left SCA with a Pipeline embolization device (PED) coupled to a microvascular plug (MVP) in the absence of antiplatelet coverage, followed by reconstruction of the BAT by deploying a second PED from the right SCA into the basilar trunk. Six-month follow-up angiography confirmed uneventful aneurysm occlusion. The patient recovered well from her neurological symptoms. This case report illustrates the successful use of a combined staged deconstructive/reconstructive endovascular approach utilizing 2 endoluminal tools, PED and MVP, to reconstruct the BAT and occlude a complex aneurysm.

scholarly journals Suprasellar epidermoid cyst: a rare cause of painless progressive bilateral vision loss-case report with clinico-radiological correlation

2018 ◽  
Vol 6 (9) ◽  
pp. 3186 ◽  
Author(s):  
Gaurav Chauhan ◽  
Vivek Singh ◽  
R. V. Phadke ◽  
Sapna Yadav
Keyword(s):  
Case Report ◽  
Vision Loss ◽  
Middle Age ◽  
Mass Effect ◽  
Neural Tube Closure ◽  
Age Group ◽  
Adjacent Structures ◽  
Post Traumatic ◽  
Intracranial Epidermoid ◽  
Tube Closure

Intracranial epidermoid cysts are relatively rare lesions. They result from inclusion of ectodermal elements during time of neural tube closure. This lesion could rarely be acquired due to post-surgical or post traumatic implantation of the ectodermal components. They typically present in middle age group patients with evidence of loco-regional mass effect on adjacent structures. We present a clinico-radiological case report of the 27-year-old female patient who presented with painless progressive bilateral vision loss for last 4 months.

scholarly journals Displaced Root of 3rd Maxillary Molar Tooth into Infratemporal Fossa- Role of 3D CT Scan

2020 ◽  
Author(s):  
Sanjay M Khaladkar ◽  
B Nagi Reddy
Keyword(s):  
Ct Scan ◽  
Infratemporal Fossa ◽  
Molar Tooth ◽  
Bony Defect ◽  
3D Ct ◽  
Maxillofacial Region ◽  
Intraoperative Complication ◽  
Adjacent Structures ◽  
3D Ct Scan ◽  
The Right

The displaced molar tooth is an unexpected and uncommon intraoperative complication of tooth extraction. Its prompt and early identification and management is crucial, as this may reduce the patient morbidity. Orthopantomogram (OPG) has limitations because of extensive anatomical superimposition of various structures. A 36-year-old female patient was referred for Computed Tomography (CT) of maxillofacial region with 3D CT scan for severe pain and swelling in right cheek region with inability to open mouth for 4 days following the dental intervention in outside dental clinic. CT scan of maxillofacial region showed bony defect in the right 3rd maxillary alveolus with multiple small bony fragments. Small fragment of molar tooth was displaced into the right infratemporal fossa and was impinging on right lateral pterygoid muscle with surrounding ill-defined soft tissue infiltrates in right retroantral fat. CT Face with 3D reconstruction helps in accurate localisation and gives appropriate anatomical detail in case of displaced molar tooth into infratemporal fossa. Thus, a detailed radiological investigation and documenting the relations of the displaced tooth or fragment with adjacent structures provides crucial information for proper surgical planning and avoiding possible complications.

Civilian Occult Orbitocranial Penetrating Injury Presenting with Cerebral Abscess in Elderly Patient

2017 ◽  
Vol 14 (02/03) ◽  
pp. 145-148
Author(s):  
Mazhar Mulla ◽  
Bhagyashri Bhende ◽  
Swapnil Patil ◽  
Aditya Patil ◽  
Batuk Diyora
Keyword(s):  
Ct Scan ◽  
Mass Effect ◽  
Interesting Case ◽  
Penetrating Injury ◽  
Case Review ◽  
Computed Tomographic ◽  
Orbital Roof ◽  
Orbital Wall ◽  
The Right ◽  
The Brain

AbstractOrbital penetrating injuries are uncommon and occur following accidental entry of objects through orbit. The authors report an interesting case of right frontal abscess resulting from orbitocranial penetrating injury due to accidental penetration of wooden stick into the right eye, which remained undiagnosed. A 70-year-man presented with complaints of headache and vomiting for few days. His computed tomographic (CT) scan of the brain revealed peripheral rim-enhancing cystic lesion in the right frontal lobe with perilesional edema, mass effect, and midline shift. Orbital CT scan revealed hyperdense lesion just lateral to medial orbital wall. Magnetic resonance imaging of the brain showed cystic peripheral rim-enhancing lesion that was homogenous hypointense on T1-weighted images and homogenous hyperintense on T2-weighted images. The patient underwent right frontal craniotomy. Pus was drained out, and abscess wall was excised. Foreign bodies protruding through fractured orbital roof were found and removed. He made good clinical recovery. He has received intravenous antibiotics for 2 weeks followed by 4 weeks of oral antibiotics. He had no visual symptoms. The authors report the case, review the literature, and highlight need for imaging in every case of orbital penetrating injury to prevent the life-threatening cerebral parenchymal complications.

Superior Hypophyseal Artery Ruptured Aneurysm in a 5-Month-Old Child Presenting as an Acute Subdural Hematoma: A Case Report

2020 ◽  
pp. 1-6
Author(s):  
Piotr Komuński ◽  
Emilia Nowosławska ◽  
Krzysztof Zakrzewski ◽  
Bartosz Polis ◽  
Wojciech Świątnicki
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Mass Effect ◽  
Ruptured Aneurysm ◽  
Treatment Modalities ◽  
Acute Subdural Hematoma ◽  
Clot Removal ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Significant Mass Effect

<b><i>Introduction:</i></b> We present a very rare case of ruptured superior hypophyseal artery (SHA) aneurysm that presented as an acute subdural hematoma (SDH) discussing its initial presentation, diagnosis, and treatment modalities. To our knowledge it is one of very few if any cases of a ruptured aneurysm in infants regarding that specific vascular location. <b><i>Case Report:</i></b> A 5-month-old boy was referred to our department due to acute SDH over the right cerebral hemisphere without significant mass effect nor hydrocephalus. Further evaluation revealed a right internal carotid artery (ICA) aneurysm arising from the SHA segment. Microsurgical clip ligation using a fenestrated, angled clip was performed with simultaneous subdural clot removal and proximal control of the ICA dissected in the neck. Our patient made an excellent recovery without any complicating features. <b><i>Conclusion:</i></b> Surgical management seems to be a better option in this subgroup of patients given the long life expectancy and durability of microsurgical clip ligation. We believe that our brief case report would add some insight into the management of this rare subgroup of patients, leading to better decision-making and outcome.

scholarly journals CD8 encephalitis in an HIVinfected patient undergoing regular antiretroviral therapy: a case report

2021 ◽  
Author(s):  
Saul Didmar Alquez Montano ◽  
José Marcos Vieira de Albuquerque Filho
Keyword(s):  
Case Report ◽  
Antiretroviral Therapy ◽  
Oral Prednisone ◽  
Undetectable Viral Load ◽  
Mass Effect ◽  
Pulse Therapy ◽  
Clonic Seizure ◽  
Mononuclear Phagocytes ◽  
Large Area ◽  
The Right

CD8 + encephalitis, and a destructive complication of HIV, that produces severe brain damage, described in patients regularly using antiretroviral therapy. It arises by viral propagation in mononuclear phagocytes leads to persistent activation of CD8 + lymphocytes. It produces demyelinating lesions, brain infiltration by CD8 + lymphocytes, and vessel hyalinization. Magnetic resonance imaging is characterized by a large area of demyelination with a mass effect and enhancement of the ring in the image. In spite of being a potentially fatal picture, it has treatment. Case report: female patient, 43 years old, with decreased strength in MSD. HIV + for 14 years on regular use of ART (Atazanavir, Tenofovir + Lamivudine and Ritonavir), CD4 +> 400 and undetectable viral load for 3 years, Alcoholist (1-2 cans beer / day). It evolved rapidly with weakness of the right hemibody, tonic-clonic seizure, inattention, and decreased level of consciousness. Liquor- cells 21 (lymphomonocyte), analysis for viruses, bacteria, mycobacteria, and negative fungus. SARS-CoV-2 detection, Blood cultures: HTLV-I and II Antibodies screening, Serology for B and C viruses - negative. WBC: 11,600 lymphocytes 27.9%. Treated with pulse therapy with 1g for 5 days. He evolved with an improvement in the level of attention, managing to walk again without help, and remission of seizures. Discharged from hospital with oral prednisone Conclusions: CD8 + encephalitis is associated with HIV despite satisfactory control rates. With an exacerbated brain immune response, there is bilateral hypersignal in the FLAIR, punctiform or linear foci of perivascular enhancements are very suggestive. At the beginning it can manifest itself as acute or subacute neurological decline, the response to corticosteroids is dramatic.

1008 Incidental Solitary Cystic Mediastinal Lymphangioma with Mass Effect Complications: A Case Report

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Youssef ◽  
S Iftikhar ◽  
M Haris ◽  
S Sundararajan ◽  
Q Abid
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Mass Effect ◽  
Brachiocephalic Vein ◽  
Plain Chest Radiograph ◽  
Complete Surgical Resection ◽  
The Right

Abstract Introduction Cystic mediastinal lymphangiomas (CML) are exceedingly rare, representing &lt;1% of cystic lymphangiomas (CL), and typically present before 2 years of age. Few cases describe adult presentations of solitary CML and none describe symptomatic cases with ‘mass-effect’ complications. We describe an incidental finding of a symptomatic solitary CML causing mass effect complications and our definitive surgical management. Case Report A 44-year-old Caucasian male presented with reduced responsiveness due to mixed drug overdose of fluoxetine and ibuprofen. Plain chest radiograph (CXR) revealed incidental new mediastinal widening. Thoracic computed tomography (CT) showed a well-defined lesion (75x63mm) in the right paratracheal region, with associated compression of the superior vena cava, left brachiocephalic vein and displacement of the azygos vein. Further questioning revealed 6-months history of non-productive cough, worsening dyspnoea on exertion and chest pain radiating to the right of the chest. Complete surgical resection was performed via posterolateral thoracotomy. It was seen compressing the 2nd and 3rd intercostal nerves. Enlarged lymph nodes at station 4 and 10 were excised and sent for analysis with aspirate from the excised lesion. Pathological gross examination showed a multiloculated cystic lesion containing thin straw-coloured fluid. Microscopically, it was thin walled with smooth muscle and scattered clusters of lymphocytes; its lining was markedly attenuated comprising bland flat endothelial cells, positive for CD-31. Lymph node samples showed reactive changes. Conclusions Although CMLs are benign, their location and growth in the mediastinum can result in compression of surrounding structures. Early detection and complete surgical resection are paramount to prevent such complications and lesion recurrence.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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