Calcification is exceedingly rare in schwannomas. In the literatures, we found only three reports of schwannomas with calcification. We report two cases of intracranial calcified schwannomas, one in the anterior cranial fossa and the other in the middle cranial fossa.
Cranial Fossa, Anterior ; Cranial Fossa, Middle ; Neurilemmoma*

OBJECTIVE: Various lesions including tumors occupying in the presellar and suprasellar regions have been traditionally removed by the transcranial approach. The new modified transsphenoidal approaches(TSAs) have been proposed to avoid the craniotomy and to get better surgical view. MATERIALS AND PATIENTS: The sellar floor and presellar anterior cranial fossa were removed through the sublabial transseptal transsphenoidal technique in the "transsphenoidal supradiaphragmatic intradural approach". One tuberculum sella meningioma and a suprasellar Rathke's cleft cyst confined to the pituitary stalk were removed via this approach. RESULTS: The dissection of the anterior intercavernous sinus, diaphragma sella, and arachnoid membrane allowed a wide surgical field of pre- and suprasellar areas and facilitated a safe removal of lesions without significant surgical complications in our cases. CONCLUSION: From the authors' limited experience, the advantages of this technique are as follows: 1) it can be easily applicable through a minor modification of the standard TSA, 2) excellent anatomical exposure of the structures located in the supradiaphragmatic suprasellar cistern, and 3) might be suitable to remove small lesions located in the presellar and adjacent to the pituitary stalk region.
Arachnoid ; Cranial Fossa, Anterior ; Craniotomy ; Humans ; Membranes ; Meningioma ; Pituitary Gland

PURPOSE: The purpose of this study was to describe the MR imaging and CT findings of intracranial inflammatory pseudotumors. MATERIALS AND METHODS: We reviewed the MR imaging (n=8) and CT (n=4) studies of eight patients (M:F = 4:4, mean age: 41 years) with pathologically proven intracranial inflammatory pseudotumor. The findings were then evaluated with regard to location, shape, MR signal intensity, CT density and degree of contrast enhancement of the lesion, surrounding parenchymal edema, adjacent bone change and the location of accompanying extracranial lesion. RESULTS: In two patients, the parietal convexity was involved unilaterally, with no extracranial mass, and in the other six, the middle cranial fossa was involved unilaterally and extracranial mass was present. The lesion also involved the tentorium in four cases, the cavernous sinus in four, the anterior cranial fossa in one, and the posterior cranial fossa in one. The location of extracranial mass was the mastoid and middle ear cavity in two cases, the infratemporal fossa in two, both the infratemporal fossa and paranasal sinuses in one, and the orbit in one. MR images showed diffuse dural thickening in all eight cases, leptomeningeal thickening in four, and focal meningeal-based mass in two. As seen on T1-weighted images, the lesions were isointense to gray matter in eight cases, and on T2-weighted images were hypointense in seven cases and isointense in one. Marked homogeneous contrast enhancement was seen in all eight cases. The lesions seen on brain CT, performed in two cases, were isodense. Adjacent brain parenchymal edema and the destruction of adjacent bones were each seen in five cases. CONCLUSION: The characteristic MR findings of intracranial inflammatory pseudotumors are(1) diffuse dural thickening;(2) a focal meningeal-based mass which on T2-weighted images is seen as hypointense; and marked (3) contrast enhancement : these findings are, however, nonspecific. In order to differentiate these tumors, an awareness of these findings is, however, useful.
Brain ; Cavernous Sinus ; Cranial Fossa, Anterior ; Cranial Fossa, Middle ; Cranial Fossa, Posterior ; Ear, Middle ; Edema ; Granuloma, Plasma Cell* ; Humans ; Magnetic Resonance Imaging* ; Mastoid ; Orbit ; Paranasal Sinuses ; Rabeprazole

Osteoma is the most common benign tumor of the cranium, and the frontal sinus is its most frequent location in the cranium. A 39-year-old woman presented with left exophthalmos was found to have orbital and intracranial extension of a giant osteoma involving anterior cranial fossa. The etiology, presenting features, diagnosis and treatment of this tumor are reviewed.
Adult ; Cranial Fossa, Anterior* ; Diagnosis ; Exophthalmos ; Female ; Frontal Sinus ; Humans ; Orbit ; Osteoma* ; Skull

Cholesterol granuloma of frontal bone is a rare disease which usually occurs at the lateral part of the supraorbital ridge. This expanding lesion grows slowly and extends into the orbit and anterior cranial fossa. The most common symptom is proptosis. This granuloma is composed of a granulomatous reaction surrounding cholesterol crystals. Surgical treatment involves aspiration of contents and stripping or curettage of the lining which is highly successful. We experienced a case of cholesterol granuloma of frontal bone with huge intracranial extension, which was cured by surgical removal. The clinical features, radiologic, and pathologic finding were discussed and the pertinent literatures were reviewed.
Cholesterol* ; Cranial Fossa, Anterior ; Curettage ; Exophthalmos ; Frontal Bone* ; Granuloma* ; Orbit ; Rare Diseases

The authors report a 12-year-old boy who had developed subfrontal recurrence of a medulloblastoma followed by postoperative whole neuroaxis irradiation. The remission persisted for about 3 years after posterior fossa surgery and radiotherapy. Then the tumor recurred in the frontal base, but local recurrence in the posterior fossa was not observed. Operative removal of the metastasis was carried out and the pathological finding was same as medulloblastoma in the posterior fossa. A pitfall of conventional whole brain radiation port is the base of the anterior cranial fossa. Then the entire subarachnoid space should be included in the postoperative radiation field for the treatment of medulloblstoma.
Brain ; Child ; Cranial Fossa, Anterior ; Humans ; Male ; Medulloblastoma* ; Neoplasm Metastasis ; Radiotherapy ; Recurrence* ; Subarachnoid Space

Choanal atresia is a rare congenital anomaly involving unilateral or bilateral posterior nasal choanal obstruction. Multiple associated anomalies have been described. We describe the case of a 1-month-old boy with bilateral choanal atresia, misdiagnosed after CT as a midline meningocele because the floor of the midline anterior cranial fossa was not ossified and secretion had accumulated in the obstructed posterior nasal choana.
Choanal Atresia* ; Cranial Fossa, Anterior ; Diagnosis* ; Humans ; Infant, Newborn ; Male ; Meningocele

Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Cavernous Sinus ; Cranial Fossa, Anterior* ; Dilatation ; Hematoma ; Superior Sagittal Sinus ; Veins

The authors report a case of esthesioneuroblastoma with intracranial extension treated by craniofacial resection. The tumor was resected by transbasal approach and repaired the dural defect using pericranial flap. The defect of floor of anterior cranial fossa was repaired with splitted calvarium and pericranial flap. Otorhinolaryngologist removed the residual tumor mass located at paranasal sinuses using lateral rhinotomy. Using cranifacial resection, the authors could remove the mass completely. The patient was referred to hemato-oncologist for chemotherapy.
Cranial Fossa, Anterior ; Drug Therapy ; Esthesioneuroblastoma, Olfactory* ; Humans ; Neoplasm, Residual ; Paranasal Sinuses ; Skull

Although reports have been assessed to locate lesions in the frontal lobe or anterior cranial fossa, the exact localization of the lesion is invariably difficult in neurological examination. However angiographic pattern is one of the most significant clue to the diagnosis of this area. For the past 2 years, from may in 1968 to December in 1970, we have analyzed angiographic patterns of space occupying lesion in the frontal lobe and anterior cranial fossa in a total of subsequent 100 cases. It is suggested that these lesions be classified into four groups according to their characteristic patterns and, for accurate localization and practical feasibility, their surgical approach. The characteristic angiographic patterns of each group are summarized as follows: (Frontal-pole) A-P view: 1. Round shift of A.C.A. 2. Flattening of carotid fork. 3. Elongation of AI. 4. No chekrein effect. 5. Sylvian point & M.C.A.... normal / (Fronto-central) A-P view: 1. Round shift of A.C.A.-mild. 2. Checkrein effect. 3. Depression of M1. 4. Flattening or mushroom appearance of carotid-fork. 5. Sylvian point... normal. / Lateral view: 1. Posterior displacement of A.C.A. 2. Vertical stretching of A2-A3. 3. Stretching of frontopolar artery. 4. Downward displacement of M2. 5. Depression of candelabra artery. 6. Closing of carotid siphon. 7. Ophthalmic artery... normal. / Lateral view: 1. Rectangular erection of C1-M1. 2. Right angle of C1-C2. 3. Elevation of M2-M3. 4. P.C.A. & ant. Choroidal artery... better. / (Fronto-lateral) A-P view: 1. Round shift of A.C.A. 2. Infrequent checkrein effect. 3. Flattering of carotid fork. 4. Vertical stretching of C1. 5. Sylvian point... normal. / Lateral view: 1. Mild stretching of A2-A3. 2. Continuous line of C2-M2. 3. Depression of M2. 4. Stretching of candelabra artery. / (Fronto-basal) A. subfrontal; A-P view: 1. Round or angular shift of A.C.A. 2. Flattening of carotid bifurcation. 3. No checkrein effect. 4. Sylvian point... normal. / Lateral view: 1. Bowing and downward convexity of A.C.A. 2. Closing of carotid siphon. 3. Depression of sylvian artery group. 4. Enlargement of ophthalmic artery. B. Inferior frontal; A-P view and lateral view: 1. Same as subfrontal lesions. 2. Relative preservation of A.C.A. branches. 3. Enlarged ophthalmic artery... mild. 4. Depression or elevation of M2.
Agaricales ; Ants ; Arteries ; Choroid ; Cranial Fossa, Anterior* ; Depression ; Diagnosis ; Frontal Lobe ; Neurologic Examination ; Ophthalmic Artery