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Bilateral temporal bone encephaloceles after cranial irradiation. Case report
A K Lalwani1, R K Jackler, G R Harsh
1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, San Francisco.
Journal of Neurosurgery
|October 1, 1993
Summary
Central nervous system irradiation can lead to complications like temporal bone encephaloceles. This case highlights a rare instance in a young adult following childhood leukemia treatment.
Area of Science:
- Neurology
- Otolaryngology
- Pediatric Oncology
Background:
- Central nervous system (CNS) irradiation is a known risk factor for long-term morbidity, including endocrine and cognitive impairments.
- Encephaloceles, particularly endaural types, are rare and typically associated with post-surgical complications.
- Prophylactic CNS irradiation was historically used in treating pediatric acute lymphocytic leukemia (ALL).
Observation:
- A 21-year-old male presented with bilateral temporal bone encephaloceles.
- The patient had a history of prophylactic CNS irradiation during early childhood for ALL.
- The encephaloceles were noted as an uncommon complication in the absence of prior mastoid surgery.
Findings:
- The case demonstrates a rare association between childhood CNS irradiation and the development of temporal bone encephaloceles.
- Radiological imaging was crucial for diagnosing the extent and nature of the encephaloceles.
- The discussion covers the etiological factors, clinical presentation, diagnostic methods, and therapeutic strategies for temporal bone encephaloceles.
Implications:
- This case underscores the potential for delayed neurological and structural complications following CNS irradiation in pediatric cancer survivors.
- Awareness of such rare complications is essential for long-term patient monitoring and management.
- Further research may elucidate the specific mechanisms linking CNS irradiation to temporal bone encephalocele formation.