Decompressive craniectomy repair using an absorbable gelatin film barrier facilitates subsequent cranioplasty by preventing adhesions between intracranial contents and the overlying galea aponeurotica and temporalis muscle fascia. This technique makes cranioplasty dissection faster and potentially safer, which may improve clinical outcomes. The indications for gelatin film should be expanded to include placement in the epidural space after craniectomy.
Transethmoidal encephaloceles are rare and most commonly present at birth with congenital abnormalities, cerebrospinal fluid rhinorrhea, or visual symptoms. Here, we report the case of a 43-year-old presenting with longstanding headache, blurry vision, anosmia, and rhinorrhea. Magnetic resonance imaging confirmed a transethmoidal encephalocele. The patient underwent craniotomy for resection of the encephalocele and repair of the cribriform defect. The postoperative course was uneventful, and the patient was discharged home with the resolution of rhinorrhea and headache. This report highlights a rare case of primary transethmoidal encephalocele undiagnosed until adulthood despite longstanding symptoms and successful treatment with resolution of symptoms.
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