Iatrogenic intradiploic meningoencephalocele

Abstract

The authors present the case of a 6-year-old girl who developed a right frontal intradiploic meningoencephalocele following an accidental dural tear produced during surgery for craniosynostosis. Although rare, growing skull fractures have been described in at least eight cases following the accidental laceration of the dura mater in the course of craniosynostosis repair. These cases closely resemble those produced by accidental trauma to the growing skull. However, the intradiploic location of a meningoencephalocele following surgery for craniosynostosis has not been documented previously. This patient presented with headache and a frontal tumor of bonelike consistency. Radiographs and computerized tomography scans of the skull revealed an intraosseous cyst, whereas magnetic resonance imaging demonstrated cerebral tissue herniation within the intradiploic tumor. Surgical treatment consisted of duraplasty and cranioplasty, which achieved good functional and cosmetic results. The pathogenesis of this unusual lesion is discussed and compared with the hypotheses advanced for explaining posttraumatic intradiploic cysts.

Parietal Intradiploic Encephalocele-Case Report-

“…5) The different diagnosis includes head trauma, multiple myelomas, dermoids, epidermoids, metastatic bone tumor, arachnoid cyst, eosinophilic granuloma, and brain tumor. 3,4) CT, MR imaging, radiography, and angiography have recently been used in the evaluation of encephalocele. In particular, MR imaging provides better information on the site and nature of the lesion as well as on associated malformations.…”

Incomplete Reossification After Craniosynostosis Surgery

“…Also, GSF after surgery, 3,38,43,19 encephalocele, 28 pseudomeningocele, 22,44 and leptomeningeal cyst, 40 ''atrogenic intradiploic meningoencephalocele after craniosynostosis surgery'' 45 are different names to describe the closely resembling situation of incomplete reossification resulting from a dura defect. Variable terminology makes it difficult to easily acquire and compare literature.…”

Post-traumatic intradiploic pseudomeningocele

“…Classically, growing skull fractures caused by the pseudomeningoceles have been described in the pediatric age group. However an intradiploic location of these pseudomeningoceles is rare; and only twenty cases are described (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). We present a four year old child who developed this uncommon condition following a traumatic injury.…”