Journal Information
Vol. 30. Issue 6.
Pages 294-299 (November - December 2019)
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Vol. 30. Issue 6.
Pages 294-299 (November - December 2019)
Case Report
Transcranial cerebellar herniation following craniotomy: Case report and literature review
Herniación cerebelosa transcraneal tras una craneotomía: reporte de un caso y revisión de la literatura
Irene Panero Pérez
Corresponding author
ipanero903@hotmail.com

Corresponding author.
, Carla Eiriz Fernández, Daniel García Pérez, Alfonso Lagares, Luis Jiménez Roldán, Jose-Antonio Fernández Alen, Ana-M. Castaño León, Igor Paredes
Department of Neurosurgery, 12 de Octubre University Hospital, Av. De Córdoba s/n, 28041 Madrid, Spain
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Table 1. “Modified Dandy criteria”: diagnosis of idiopatic intracranial hypertension.16
Abstract

To report a case of post-surgical encephalocele through craniotomy burr holes following the resection of a meningioma of the posterior fossa. A 49-year-old female presented in the emergency room with cephalea. The MRI showed a meningioma of the convexity of the posterior fossa. A resection was performed and the bone flap replaced. The patient recovered uneventfully and was discharged. After 30 days the patient consulted referring cephalea, vomiting and imbalance. Brain MRI revealed a trans-cranial cerebellar herniation through the craniotomy burr holes. An urgent surgery was performed to repair the encephalocele. Post-surgical brain MRI was performed and did not show complications.

Post-surgical encephalocele is an uncommon complication after the resection of a posterior fossa lesion. To avoid this complication, it is recommended thorough dural and bony closure, particularly in the posterior fossa surgeries and in high-risk patients.

Keywords:
Postoperatively encephalocele
Post-surgical encephalocele
Trans-cranial herniation
Craniotomy
Cranioplasty
Abbreviations:
MRI
SFC
ICP
Resumen

Reportamos un caso de un encefalocele posquirúrgico tras la realización de una craneotomía para la resección de un meningioma de fosa posterior. Se trata de una mujer de 49 años que acude al servicio de urgencias por cefalea. Se realizó una resonancia magnética (RM) cerebral que mostró un meningioma de la convexidad en fosa posterior. Se realizó su resección quirúrgica y reposición del colgajo óseo. La paciente se recuperó sin incidencias y fue dada de alta. Treinta días más tarde consultó por cefalea, vómitos e inestabilidad. Se realizó una RM que mostró una herniación cerebelosa a través de los orificios de trépano de la craneotomía, por lo que se llevó a cabo una reparación quirúrgica urgente del encefalocele. Se realizó una RM posquirúrgica, la cual no mostró complicaciones.

El encefalocele posquirúrgico es una complicación poco frecuente tras la resección de un meningioma de fosa posterior. Para evitar esta complicación se recomienda realizar un cierre dural y una reposición ósea cuidadosos, particularmente en las cirugías de fosa posterior y en pacientes con alto riesgo.

Palabras clave:
Encefalocele postoperatorio
Encefalocele posquirúrgico
Herniación transcraneal
Craneotomía
Craneoplastia

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