Acquired Encephalocele With Hydrocephalus and Pineal Region Epidermoid Cyst.
A combination of trauma and a missed inflammatory response (nasal operation) concomitant with hydrocephalus and tumor in secondary encephalocele has not been described in the English literature yet. A 38-year-old man was admitted to the clinic with rhinorrhea that started 3 months ago. In his medical history, nothing abnormal was present except a nasal operation performed 1 year ago. Brain magnetic resonance imaging depicted left frontal encephalocele concomitant with obstructive hydrocephalus caused by an epidermoid cyst originated from the pineal region. A 2-staged surgery was planned. In the first stage, a ventriculoperitoneal shunt insertion was conveyed successfully. In the second-stage surgery, the herniated brain tissue was excised, and the frontal sinus was cleansed with serum saline combined with antibiotic. The bony defect and the dura defect were repaired. The patient's presenting complaint recovered fully, and he was discharged to home in a well condition. Acquired encephalocele is a rare entity. In case of rhinorrhea and encephalocele, even in the presence of prior history of nasal surgery, intracranial evaluation should be conveyed to exclude the presence of hydrocephalus and/or tumor. The cranial defect should be repaired to prevent future infections and brain tissue damage.
*Department of Neurosurgery, Bahçeşehir University Medical School, Istanbul, Turkey †Department of Orthopedic Surgery-Spine Center, University of California, San Francisco, CA ‡Department of Anesthesiology, Medical Park Göztepe Hospital §Department of Radiology, Bahçeşehir University Medical School, Istanbul, Turkey.
Zafer Orkun
ZO
Toktaş
Baran
B
Yilmaz
Murat Şakir
MŞ
Ekşi
Ahmed B
AB
Bayoumi
Akin
A
Akakin
Yasin
Y
Yener
Mustafa Kemal
MK
Demir
Türker
T
Kiliç
D000328:Adult; D020863:Central Nervous System Cysts / Q000150:complications* / Q000175:diagnosis; D004677:Encephalocele / Q000150:complications / Q000175:diagnosis*; D004814:Epidermal Cyst / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010870:Pineal Gland; D014057:Tomography, X-Ray Computed