Unusual Skull Base Lesion: Hemangiopericytoma of the Middle Cranial Fossa

Meningioma is the most common intracranial tumor affecting the skull base and the diagnosis is usually straightforward on imaging studies. However, other lesions may present similar findings. A 60 year-old-man presented with memory loss and behavioral changes. Computed Tomography (CT) and Magnetic Resonance (MR) imaging disclosed an extra-axial, dural-based lesion of the middle cranial fossa. The lesion was strongly enhanced and of hypervascular nature, peripheral vessels and vasogenic edema of the adjacent brain parenchyma. Although the most common dural-based lesion of the central nervous system (CNS) is the meningioma, radiologists should be aware of other differential diagnoses, particularly when facing atypical imaging features. These comprise metastases, lymphoma and leukemia, histiocytic lesions, sarcoidosis and hemangiopericytoma. Based on imaging findings we were able to suggest the hemangiopericytoma diagnosis and the patient was subject to tumoral resection surgery and adjuvant radiotherapy. A small tumoral residue remains stable on follow-up studies.info:eu-repo/semantics/publishedVersio

The bath-plug closure of anterior skull base cerebrospinal fluid leaks

BackgroundThis study presents the technique and results of cerebrospinal fluid (CSF) leak closure by placement of a fat plug on the intracranial surface of the dura. A prospective cohort study of all consecutive patients undergoing endoscopic closure of an anterior skull base CSF leak using the bath-plug technique was performed at a tertiary care center.MethodsThirty-three patients presented with CSF leaks: 6 were traumatic, 7 were spontaneous, 9 were iatrogenic, and 10 were associated with a meningoencephalocele. The average age of the patients was 40 years and the male-to-female ratio was 1.2:1. All patients underwent the bath-plug technique for closure of CSF leaks. The surgical technique was presented.ResultsThirty-one of the 33 patients had a successful primary closure of their CSF leak with 2 patients requiring a repeat procedure. After an average of 28 months follow-up, there were no recurrent leaks in any of the patients. This gives a primary closure success rate of 94% and a secondary closure rate of 100%.ConclusionThe bath-plug technique for closure of anterior skull base CSF leaks was a reliable technique for a large variety of causes