PMC4683796_01
(a) Axial computed tomography head demonstrating erosion of the inner table of the right frontal bone. (b) Coronal computed tomography head demonstrating erosion of the inner table of the right frontal bone
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F1
The computed tomography (CT) of her head demonstrated a 3.7 cm x 3.4 cm x 1.5 cm lytic lesion of the right frontal calvarial bone with the erosion of the inner table [Figure 1].
(a) Axial T1-weighted magnetic resonance imaging with heterogeneous hypointensity of the right frontal lobe lesion. (b) Axial T2-weighted magnetic resonance imaging with heterogeneous hyperintensity of right frontal lobe lesion. (c) Coronal T2-weighted magnetic resonance imaging with heterogeneous hyperintensity of right frontal lobe lesion
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F2
The magnetic resonance imaging (MRI) of her brain suggested herniation of the right frontal lobe parenchyma into the bony defect [Figure 2].
(a) Intraoperative photograph of meningoencephalocele herniating through the inner calvarial table. (b) Intraoperative photograph of fontal bone lesion
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F3
As the bone flap was elevated, brain tissue was noted to have herniated into the calvarial lesion [Figure 3a]. The bone flap was inspected on the surgical table [Figure 3b], and the inner table was removed prior to the replacement of the bone flap and closure.
(a) Cerebral cortex with a bone, that is, intermingled with arachnoidal cells; H and E (scale bar = 100 mum). (b) Gliotic cerebral cortex with thickened leptomeninges; H and E (scale bar = 100 mum)
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F4
The permanent sections, stained with hematoxylin and eosin [Figure 4], confirmed the frozen findings and also demonstrated gliosis of the cerebral cortex with thickening of the leptomeninges within the defect in the skull.