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Case 35
Published in Simon Lloyd, Manohar Bance, Jayesh Doshi, ENT Medicine and Surgery, 2018
Simon Lloyd, Manohar Bance, Jayesh Doshi
The likely diagnosis is a meningoencephalocoele (brain hernia) into the right mastoid cavity. In this case, the T2 images suggest that the contents of the hernia are primarily cerebrospinal fluid (CSF). In other cases, the hernia is primarily full of brain tissue which is devitalised and non-functional. An example of a meningoencephalocoele containing more brain tissue is shown below (left hand side).
The rare manifestations in tuberculous meningoencephalitis: a review of available literature
Published in Annals of Medicine, 2023
Rong li He, Yun Liu, Quanhui Tan, Lan Wang
Continuously increased brain pressure is prone to brain hernia, mainly tentorial hernia, axial hernia and foramen magnum hernia [1]. In the late stage of the brain nodule, when the arachnoid membrane of the skull base is widely adhered or the tuberculous inflammation directly invades the nerve, cranial nerve paralysis will occur. Tuberculous spinal meningitis and arachnoiditis, formation of intramedullary granuloma or tuberculous fibrous exudate around the spinal cord and nerve root, often lead to paraplegia, dysuria and nerve root pain. Tuberculous vasculitis throughout the course of the disease is prone to large vessel occlusion, leading to cerebral infarction, tuberculous granuloma and tuberculous abscess compressing brain parenchyma, as well as hemiplegia, such as simultaneous aphasia of dominant hemisphere.
Spontaneous acute epidural hematoma associated with chronic subdural hematoma due to dural metastasis of gastric carcinoma: a case report and literature review
Published in International Journal of Neuroscience, 2021
Chenhui Zhao, Yi Wei, Jie Liu, Shanshui Xu, Xiaochun Jiang, Guangfu Di
However, spontaneous hemorage caused by dural metastasis is different from that of coagulopathy [32]. And the detailed mechanism underlying this phynomenon has not been certainly elucidated. As to the pathgenesis of SDH with dural metastasis, one explanation is that chronic SDH is arised from the fragil vessels of metastasis tumor [33]. Whereas, Russel et al. [3] considered that the tumor embolus embolized the outer epidural relatively hard and tough vein, which causes rupture of the loose vein in inner dura mater, forming a SDH. Tasaki et al. [34] reported a case of dural hematoma with SDH and pathological examination confirmed cancerous embolism in capillaries of skull and dural. Combined with the patient’s immunohistochemistry results, intravascular tumor thrombus, presence of granular new organisms in the outer layer of the dura mater and the smooth of the inner layer, it is likely that the tumor may be transferred through the extracervical vascular system by the blood pathway. Of course, this is just our speculation. As to this case, hemorrhage occured in distinct intracranial location in different periods. The chronic compression of the SDH made the patient gradually tolerate increased intracranial pressure. When running across an acute EDH, the patient’s condition changed swiftly with the development of hematoma mass effect. Considering the patient’s medical history, the brain hernia had a short prodromal stage and rapidly developed into peek period.
Clinical features of Chinese patients in different age groups with spontaneous intracerebral hemorrhage based on multicenter inpatient information
Published in Neurological Research, 2020
Pingping Wang, Yong Sun, Danhui Yi, Yanming Xie, Yumin Luo
This study showed the incidence of complications such as brain hernia, upper gastrointestinal bleeding, epilepsy was higher in younger patients. These complications were reported associated with ICH volume growth and poor outcome [22,23]. Clinically, this population should be dynamically monitored for intracranial pressure, imaging examination, clinical signs and analyzed in a timely manner to provide effective interventions for the reduction in the incidence of hernias and other malignant complications. Pulmonary infection, urinary tract infections, electrolyte metabolism disorders and pressure injury were more common in older patients. Therefore, attention should be paid to the clinical care of the respiratory tract, urinary tract, skin and electrolyte conditions of elderly patients. The application of drugs, such as dehydration drugs and antihypertensive drugs, that easily lead to electrolyte imbalance should be carefully used and dynamically monitored in these patients.