MyPACS.net: Radiology Teaching Files > Case 60718470

Last visited 05/31/2012 OCCIPITAL MENINGOCELE
Contributed by: Faculty and residents Children's Hospital, Radiologist, Children's Health System, Birmingham, Alabama., USA.
Patient: 1 day old male
History: 0 year 0 month 0 week 1 day old male
Images:[small]larger

Fig. 1: Large posterior fossa fluid collection extends through a occipital skull defect. Elevation of torcula herophili and presence of cerebellar vermis.

Fig. 2: Fluid collection extending from posterior fossa through occipital skull defect. No evidence of cord or cerebellar contents herniating through skull defect.

Fig. 3: Small residual outpouching of fluid within previously repaired occipital skull defect.

Fig. 4: Marked residual hydrocephalus and cortical thinning after occipital decompression and VP shunting
Findings:

Markedly enlarged posterior fossa being occupied by fluid collection with the fluid collection not communicating with the fourth ventricle.

Fluid collections extends through an occipital skull defect, however, there is no appreciable brainstem, cervical cord or cerebellar herniation into the extracranial fluid collection.

Elevation of the torcula herophili along with anterior displacement/compression of the brainstem

Cerebellar vermis are present; however cerebellar hemispheres are absent. No cerebellar tonsillar herniation.

Marked hydrocephalus

 

Diagnosis: Occipital Myelomeningocele
Discussion:
  • Herniation of intracranial structures through skull defect
    • Cephalocele
      • More generic term
      • Herniation of intracranial contents
    • Encephalocele
      • Meninges + brain
      • Most common
    • Cranial meningocele
      • Meninges only
    • Chiari III
      • Hindbrain malformation
      • Cerebellum herniated into cephalocele

Encephaloceles: 75% occipital, 10% Frontoethmoidal, others locations are much less common

Must evaluate contents of encephalocele  along with involvement of adjacent dural sinus as this determines prognosis and future surgical planning.

Often associated with hydrocephalus secondary to disruption of CSF flow

References: Stat Dx
Comments:
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Additional Details:

Case Number: 60718470Last Updated: 2012-05-31
Anatomy: Cranium and Contents   Pathology: Congenital
Modality: MRAccess Level: Readable by all users

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