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Brainstem herniation into the internal acoustic canal secondary to hydrocephalus in context of spontaneous cerebrospinal fluid otorrhea: report of a novel entity

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Abstract

Introduction and clinical presentation

The authors report a case of a 5-year-old boy presenting with vision loss, right-sided hearing loss, and facial paralysis secondary to hydrocephalus causing brainstem herniation into the internal auditory canal (IAC) following cerebrospinal fluid (CSF) otorrhea.

Management and outcome

After placement of a ventriculo-peritoneal shunt (VP shunt), the vision and facial palsy improved whilst hearing loss persisted. Imaging demonstrated partial reduction of the herniated brainstem and resolution of hydrocephalus. To our knowledge, this is the first case reported of brainstem herniation into the internal auditory canal.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, George Washington University, 2150 Pennsylvania Ave. NW, Washington, DC, 20037, USA

    Cristian Gragnaniello

  2. Division of Neurosurgery, Children’s National Health System, Washington, DC, 20010, USA

    John S. Myseros

  3. Department of Radiology, George Washington University, 2150 Pennsylvania Ave. NW, Washington, DC, 20037, USA

    Reza Taheri

  4. Department of Otolaryngology, George Washington University, 2150 Pennsylvania Ave. NW, Washington, DC, 20037, USA

    Ashkan Monfared

Authors
  1. Cristian Gragnaniello
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  2. John S. Myseros
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  3. Reza Taheri
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  4. Ashkan Monfared
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Corresponding author

Correspondence to Cristian Gragnaniello.

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The authors whose names are listed above as authors of this manuscript certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Gragnaniello, C., Myseros, J.S., Taheri, R. et al. Brainstem herniation into the internal acoustic canal secondary to hydrocephalus in context of spontaneous cerebrospinal fluid otorrhea: report of a novel entity. Childs Nerv Syst 34, 349–352 (2018). https://doi.org/10.1007/s00381-017-3593-9

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  • DOI: https://doi.org/10.1007/s00381-017-3593-9

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