Cysts Of Middle Cranial Fossa Research Articles

A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit.

Background:Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically.Methodology:An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done.Results:On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst.Conclusions:Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.

Imaging Evaluation of Pediatric Sensorineural Hearing Loss in Potential Candidates for Cochlear Implantation.

Computerized tomography (CT) and magnetic resonance (MR) are complementary in the imaging of the labyrinth, the internal auditory canal and the brain in children with sensorineural hearing loss who are being evaluated for cochlear implantation. An accurate anatomical description of the inner ear is essential in the preoperative work up. Computerized tomography visualizes the bony structures, whereas MR can discern soft-tissue components including intra labyrinthine fluid, cerebrospinal fluid (CSF), nerves, and vessels within the IAC. This prospective study was conducted in the Department of Otorhinolaryngology, Head & Neck Surgery, Government Medical College, Srinagar. 40 children in the age group of 1-16years with unidentified causes of bilateral SNHL were analysed radiologically over the period of 2years from Dec 2011 to Jan 2014. Each patient underwent MRI and high resolution CT scanning of temporal bone in axial and coronal planes. Out of the 40 patients 22 were males (55%) and 18 were females (45%). 30 patients (72.5%)in our study had normal radiological scans. Five patients (12.5%) had B/L large vestibular aqueduct and two patients (5%) had internal auditory canal stenosis with cochlear nerve hypoplasia on CT and MR imaging. Cochlear dysplasia was present in two patients (5%) and semicircular canal dysplasia was present in one patient (2.5%) as an isolated finding on HRCT. In addition isolated cochlear nerve hypoplasia was present in one patient (2.5%). Hyperintense basal ganglia lesion suggestive of kernicterus was present in one patient (2.5%) and hyperintense posterior parietal and occipital white matter lesions suggestive of congenital CMV infection was present in one patient (2.5%) on MR imaging. Arachnoid cysts of middle cranial fossa was an incidental finding present in one patient. Radiological abnormalities of the inner ear are not uncommon. Computerized tomography and MRI are important modalities to analyze the inner ear in children with unexplained SNHL. MRI with an extremely small field of view should be used to study possible abnormalities of the vestibulocochlear nerves.

Arachnoid Cyst in the Middle Cranial Fossa Presenting with Pulsatile Exophthalmos: Case Report and Literature Review

A 20-year-old woman suffered gradual progression of right pulsatile exophthalmos and slight headache. Computed tomography (CT) demonstrated outward and downward displacement of the right globe and an arachnoid cyst in the right middle cranial fossa associated with thinned and anterior protrusion of a bony orbit. Microscopic cystocisternotomy was performed and the cerebrospinal fluid (CSF) inside of the cyst communicated into the carotid cistern and cistern in the posterior cranial fossa. Pulsatile exophthalmos improved immediately after surgery. Arachnoid cyst in the middle cranial fossa presenting with exophthalmos is rare. Microscopic cystocisternotomy might successfully improve CSF flow and relieve exophthalmos.

Galvos smegenų arachnoidinių cistų endoskopinis gydymas

Arachnoid cyst is a congenital collection of fluid similar like cerebrospinal fluid between the leaves of arachnoid. Usually they have no connections with subarachnoid space. Symptomatic arachnoid cysts are treated surgically. The method of surgical treatment depends according to the cyst location, surgeons experience and available instruments. The methods of arachnoid cysts surgical treatment are: craniotomy and open cyst extirpation and connection with subarachnoid space, endoscopic cyst aspiration and connection with subarachnoid space (cystocysternostomy) or ventricles (cystoventriculostomy) and cystoperitoneal shunting. We describe the method of endoscopic treatment of arachnoid cysts and review the clinic, diagnostic and early results of patients treated at the Department of Neurosurgery, Klaipėda University Hospital. There were 6 patients who underwent endoscopic surgery for arachnoid cysts during the period from January 2011 till January 2013. Four patients (66.7 proc.) had arachnoid cysts of middle cranial fossa and two (33.3 proc.) had intraventricular arachnoid cysts. Four patients underwent endoscopic cystocysternostomy and two patients underwent endoscopic cystoventriculostomy and cystoventriculocysternostomy. We observed early improvement in all patients. Diabetes insipidus has developed to one patient as a complication of surgery. Conclusion. Endoscopic surgery for arachnoid cysts is an effective, safe and minimally invasive treatment method. It must be the first method of surgery for most symptomatic arachnoid cyst. doi:10.5200/sm-hs.2013.071

Endoscopic treatment of middle fossa arachnoid cysts

To investigate and evaluate the effectiveness of neuroendoscopic therapy for arachnoid cysts of middle cranial fossa. From January 2004 to June 2009, 32 patients with arachnoid cysts of middle cranial fossa who were treated with endoscopic cystocisternal fenestration were retrospectively analyzed. There were 21 male patients and 11 female patients, aged from 6 months to 39 years. The clinical and neuroradiological presentation, indications, surgical technique, complications, and clinical and neuroradiological follow-up were analyzed. The cysts were reduced in size in 20 patients and completely disappeared in 4 patients. For the 27 patients with symptoms before operation, the symptoms disappeared in 8 cases and improved in 17 cases after operation. There were asymptomatic subdural hydroma in 4 patients, intracranial infection and incision cerebro-spinal fluid leakage in 1 patient respectively. The complication incidence rate was 18.8%. Endoscopic fenestration is an effective treatment for symptomatic arachnoid cysts of middle cranial fossa and could be performed as the first surgical choice for these patients.