scholarly journals Anterior sacral meningocele repair assisted by intraoperative intrathecal fluorescence and 3D printing model: illustrative case

2021 ◽  
Vol 1 (20) ◽  
Author(s):  
Yu-Chaing Yeh ◽  
Ya-Jui Lin ◽  
Chih-Hua Yeh ◽  
Pao-Shiu Hsieh ◽  
Chieh-Tsai Wu
Keyword(s):  
Marfan Syndrome ◽  
Ovarian Cyst ◽  
Primary Repair ◽  
Brain Magnetic Resonance Imaging ◽  
Pelvic Mass ◽  
Illustrative Case ◽  
Subdural Effusion ◽  
Csf Leakage ◽  
Anterior Sacral Meningocele ◽  
3D Printed

BACKGROUND Marfan syndrome is rarely accompanied by anterior sacral meningocele (ASM) resulting from erosion of the sacrum by dural ectasia. ASM may induce symptoms due to severe mass effects. ASM may also mimic ovarian cysts, and the risk of cerebrospinal fluid (CSF) leakage is high if spontaneous rupture of the cyst occurs. In this study, the authors presented a rare case of ASM with iatrogenic CSF leakage in a 34-year-old woman with suspected Marfan syndrome. OBSERVATIONS The patient initially presented with a giant ASM that was first misdiagnosed as an ovarian cyst. Previously, it had been partially resected, which was followed by iatrogenic CSF leakage. Symptoms of intracranial hypotension, including postural headache and dizziness, developed within 1 month. Brain magnetic resonance imaging (MRI) showed pituitary enlargement, bilateral subdural effusion, and tonsillar herniation. Preoperative computed tomography myelography provided three-dimensional (3D) examination of the deformed sacrum and CSF leakage site. Transabdominal approaches led to primary repair, and repair of the meningocele was achieved by intraoperative fluorescein fluorescence and 3D printed model–guided polymethyl methacrylate bone cement reconstruction. No CSF leakage or recurrent ASM was found at the 1.5-year follow-up visit. LESSONS Intraoperative intrathecal fluorescence and 3D-printed models are useful for ASM repair. Preoperative MRI is helpful for differentiating ASM from other causes of a huge pelvic mass, including ovarian cyst.

scholarly journals Anterior sacral meningocele masquerading as an ovarian cyst: a rare clinical presentation associated with Marfan syndrome

2015 ◽  
Vol 5 (2) ◽  
Author(s):  
Neslin Sahin ◽  
Mine Genc ◽  
Esin Kasap ◽  
Aynur Solak ◽  
Berrin Korkut ◽  
...  
Keyword(s):  
Marfan Syndrome ◽  
Ovarian Cyst ◽  
Clinical Presentation ◽  
Anterior Sacral Meningocele

ROMA guided conservative management for women diagnosed with an ovarian cyst or pelvic mass

2015 ◽  
Vol 136 (2) ◽  
pp. 399
Author(s):  
E. Lokich ◽  
M. Palisoul ◽  
N. Romano ◽  
C. Raker ◽  
C. Miller ◽  
...  
Keyword(s):  
Ovarian Cyst ◽  
Conservative Management ◽  
Pelvic Mass

scholarly journals Complete resolution of a giant multilocular prostatic cystadenoma following androgen deprivation therapy: an illustrative case report

2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Nikita Sushentsev ◽  
Yvonne Rimmer ◽  
Tristan Barrett
Keyword(s):  
Androgen Deprivation Therapy ◽  
Complete Resolution ◽  
External Beam Radiotherapy ◽  
Pelvic Mass ◽  
Androgen Deprivation ◽  
Illustrative Case ◽  
Imaging Features ◽  
First Case ◽  
Complete Surgical Resection ◽  
Risk Prostate Cancer

ABSTRACT Giant multilocular prostatic cystadenoma (GMPC) is a rare benign pelvic mass for which complete surgical resection is an accepted treatment of choice. This report presents the first case of complete resolution of GMPC following a 3-year course of luteinising hormone-releasing hormone agonist alongside external beam radiotherapy for the concurrent treatment of unfavorable intermediate-risk prostate cancer. In addition to illustrating the imaging features of the effect of androgen deprivation therapy (ADT) and radiotherapy on GMPC regression, this case provides evidence for considering ADT as an alternative, noninvasive GMPC treatment option in patients in whom surgical treatment is either contraindicated or can be made less invasive by reducing the size of GMPC prior to its removal.

scholarly journals Iatrogenic cerebrospinal fluid leak after repeated nasal swab tests for COVID-19: illustrative case

2021 ◽  
Vol 2 (17) ◽  
Author(s):  
Johnson Ku ◽  
Chieh-Yi Chen ◽  
Jason Ku ◽  
Hsuan-Kan Chang ◽  
Jau-Ching Wu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Nasal Swab ◽  
Cerebrospinal Fluid Leak ◽  
Cribriform Plate ◽  
Csf Leak ◽  
Illustrative Case ◽  
Endoscopic Endonasal ◽  
Csf Rhinorrhea ◽  
Csf Leakage

BACKGROUND Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. OBSERVATIONS A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. LESSONS Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.

Rupture of Giant Anterior Sacral Meningocele in a Patient with Marfan Syndrome: Diagnosis and Management

2018 ◽  
Vol 119 ◽  
pp. 137-141
Author(s):  
Alex M. Hollenberg ◽  
Avionna L. Baldwin ◽  
Addisu Mesfin ◽  
Howard Silberstein
Keyword(s):  
Marfan Syndrome ◽  
Diagnosis And Management ◽  
Syndrome Diagnosis ◽  
Anterior Sacral Meningocele

scholarly journals A study on clinical analysis and surgical outcomes of occipital encephalocele in children

2021 ◽  
Vol 8 (10) ◽  
pp. 2946
Author(s):  
Harisinh V. Parmar ◽  
Nilay S. Adhvaryu ◽  
Jaimin K. Shah ◽  
Bhargav Trivedi ◽  
Milap Parmar
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Clinical Analysis ◽  
Folic Acid Supplementation ◽  
Postnatal Period ◽  
Resonance Imaging ◽  
Occipital Encephalocele ◽  
Csf Leakage ◽  
Poor Neurological Outcome ◽  
The Brain ◽  
Tomography Scan

Background: Occipital encephalocele is the commonest of encephalocele involving protrusion of meningeal and neural structures through the occipital bone defects. It is a congenital anomaly with varied presentation and can include only meninges to the cerebellum, medulla, venous sinus and brainstem structure.Methods: Study was done at civil hospital Ahmedabad from January 2017 to January 2020 occipital encephalocele patients were operated at the department of neurosurgery. The patients were evaluated by computed tomography scan of the brain, magnetic resonance imaging and ultrasound. The operated cases were reviewed and relevant data such as age, sex, location of encephalocele, the size of the lesion, operative method, seizure and hydrocephalus along with postoperative complications were recorded for analysis.Results: In our study, we have better results in contrast to literature may be due to absence of hydrocephalus, other anomalies of brain, seizure disorder and lack of functional brain tissue within the sac as these factors has been associated with poor neurological outcome. Out of 35 operated, 2 patients expired of which 1 patient had other complication at presentation and other one had had developed cerebrospinal fluid (CSF) leakage with ventriculitis.Conclusions: Repair of encephaloceles should be ideally done in the postnatal period to minimize risks of ulceration and trauma to the lesion with subsequent meningitis. We can conclude that folic acid supplementation should be strongly emphasized in health centres to reduce these neural tube defects as none of the patients in our study has taken.

scholarly journals Does the timing of surgery affect short-term prognosis in newborn infants with meningomyelocele?

2020 ◽  
Author(s):  
Mustafa Kurthan Mert ◽  
Ali İhsan Ökten
Keyword(s):  
Primary Repair ◽  
Newborn Infants ◽  
Early Surgery ◽  
Associated Anomalies ◽  
Short Term ◽  
Surgery Group ◽  
Number Of Patients ◽  
Csf Leakage ◽  
Antibiotic Duration ◽  
Average Size

Abstract Objective: To investigate the effect of postnatal primary repair surgery time on short-term (first 30 days) prognosis in neonates with meningomyelocele (MMC).Methods: The records of meningomyelocele patients treated at Adana City Training and Research Hospital between June 30, 2015 and August 1, 2019 were retrospectively reviewed. Demographic and clinical characteristics, surgical time, hospitalization and antibiotic duration, complications and associated anomalies were recorded.Results: Data of 41 patients were evaluated. The patients were divided into two groups according to the time of surgery. There were 18 patients in the early surgery (≤3 days) group and 23 patients in the late surgery (>3 days) group. There was no difference between groups in terms of birth weight, gestational week, head circumference, sex and type of delivery (p>0.05). The length of hospitalization was 17.2 ± 8.2 in the early surgery group and 24.8 ± 16.1 in the late surgery group (p>0.05). Antibiotic duration was 11.8 ± 7.6 in the early surgery group and 13.8 ± 10.1 in the late surgery group (p>0.05). There was no difference between the two groups between the average size of the MMC sac (5.4±1.1 vs 6.1±2.3, p>0.05). The number of patients with postoperative complications in early surgery group was 8 (44.4%) and in late surgery group was 7 (30.4%), and the number of patients reoperated in the first 30 days in early surgery group was 5 (27.7%) and in late surgery group was 6 (26.1%). The number of patients requiring ventriculoperitoneal shunt (VPS) was 9 (50%) in the early surgery group and 13 (56.5%) in the late surgery group. Surgical complications minor-major dehiscences, CSF leakage, local infection, meningitis and ventriculitis are not statistically different between the groups (p>0.05).Conclusion: Although postnatal early surgical intervention in MMC positively affects short-term outcomes, short-term prognosis is also determined by the presence of associated anomalies, VPS placement time, and rupture of the sac.

scholarly journals Difference in the incidence of cerebrospinal fluid leakage and residual tumors between functional and nonfunctional pituitary adenomas treated by endoscopic transsphenoidal pituitary adenomectomy

2019 ◽  
Vol 47 (11) ◽  
pp. 5660-5670
Author(s):  
Ching-Yi Lee ◽  
Yuan-Chuan Chen ◽  
Ying-Piao Wang ◽  
Shiu-Jau Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Diabetes Insipidus ◽  
Pituitary Adenomas ◽  
Symptom Relief ◽  
Brain Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid Leakage ◽  
Large Tumor ◽  
Endoscopic Endonasal ◽  
Csf Leakage ◽  
Nonfunctional Pituitary Adenomas

Objective This study compared the incidence of cerebrospinal fluid (CSF) leakage and residual tumors between functional and nonfunctional pituitary adenomas treated with the endoscopic endonasal transsphenoidal approach (EETA). Methods All patients underwent endocrine examinations and brain magnetic resonance imaging before and after surgery. The length of admission, incidence of central diabetes insipidus, incidence of CSF leakage, symptom relief, and presence of residual tumors were compared between patients with functional and nonfunctional pituitary adenomas. Results Thirty-eight patients were enrolled, among whom 12 and 26 had functional and nonfunctional pituitary adenomas, respectively. The incidence of CSF leakage was significantly higher in patients with nonfunctional adenomas; a hard or elastic tumor character accounted for the difference. A large tumor size and cavernous sinus invasion were risk factors for residual tumors. No significant differences were found in sex, length of admission, operative times, incidence of diabetes insipidus, or number of residual tumors between the two groups. The hormone levels were lower postoperatively than preoperatively in patients with nonfunctional adenomas. Conclusion Nonfunctional pituitary macroadenomas resulted in more CSF leakage. Use of the rescue nasoseptal flap reduced unnecessary nasal destruction. Cooperation between a neurosurgeon and otolaryngologist was safer and more effective when using the EETA.

Anterior Sacral Meningocele Wrongly Diagnosed as Ovarian Cyst

2010 ◽  
Vol 46 (3) ◽  
pp. 245-246 ◽  
Author(s):  
K.Y. Vamsi ◽  
P. Sarat Chandra ◽  
B.S. Sharma ◽  
A.K. Mohapatra
Keyword(s):  
Ovarian Cyst ◽  
Anterior Sacral Meningocele
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