Caudal vena cava collapsibility index in healthy cats by ultrasonography / [Índice de colapsibilidade da veia cava caudal em gatos domésticos Saudáveis, obtido por meio de ultrassonografia]

The objective of this study was to calculate the collapsibility index (CI) in a group of 15 healthy adult mixed breed cats via right hepatic intercostal ultrasound view. The minimal and the maximal diameters of the caudal vena cava (CVC) were obtained during inspiration and expiration, respectively, then CI was calculated. The mean diameter of the CVC was 0.5cm. The mean CI was 28±3% and CI was not significantly associated with gender. As in human medicine, there is a growing need for less invasive monitoring in small animal practice. The CI enables the assessment of estimated volemia without the need for a central venous catheter. This is the first reported study investigating CI in cats.(AU)

O objetivo deste estudo foi calcular o índice de colapsabilidade (IC) em um grupo de 15 gatos adultos, saudáveis e SRD, por meio da janela ultrassonográfica hepática intercostal direita. Os diâmetros mínimo e máximo da veia cava caudal (VCC) foram obtidos durante a inspiração e a expiração, respectivamente. O IC foi calculado, posteriormente. O diâmetro médio da VCC foi de 0,5cm. O diâmetro médio do IC foi de 28±3%, e o IC não foi significativamente associado ao gênero. Como na medicina humana, há uma necessidade crescente de monitoramento menos invasivo na prática de pequenos animais. O IC possibilita a avaliação da volemia estimada sem a necessidade de um cateter venoso central. Este é o primeiro estudo relatado sobre IC em gatos domésticos.(AU)

Crossed renal ectopia with fusion in a female feline: case report / Ectopia renal cruzada com fusão em uma gata: relato de caso

A 3 year old female feline of mixed breed was sent to the diagnostic imaging sector under suspicion of bleeding due to ovariohysterectomy. An abdominal ultrasonography was performed to confirm the initial suspicion. However, no signs of bleeding were found, instead it was observed that the left renal silhouette had two pelvises and was elongated and larger than normal. The right kidney was not found. Excretory urography was requested to evaluate the condition of the ureters. The final diagnosis was crossed renal ectopia with fusion in an asymptomatic cat with no changes in renal function.(AU)

Uma gata, sem raça definida, com três anos de idade, foi encaminhada para o setor de diagnóstico por imagem sob suspeita de hemorragia devido à ovário-histerectomia. Foi realizada ultrasonografia abdominal para confirmar a suspeita inicial, mas nenhum sinal de hemorragia foi encontrado; visibilizou-se, entretanto, a silhueta renal esquerda alongada, com presença de duas pelves. O rim direito não foi encontrado. Solicitou-se exame de urografia excretora para avaliação de ureteres. O diagnóstico foi de ectopia renal cruzada com fusão em um felino assintomático e sem alterações na função renal.(AU)

Ultrasonography and theloscopy for the diagnosis of obstructive fibrosis in the Fürstenberg venous ring in the four quarters of the udder of a cow: a case report / Ultrassonografia e teloscopia no diagnóstico de fibrose obstrutiva do anel venoso de Fürstenberg em quatro quartos mamários em bovino: relato de caso

We report an unusual case of obstructive fibrosis of the venous ring of Fürstenberg in all four quarters of the udder of a cow of the Girolando breed (3/8 Gir and 5/8 Dutch). The information was obtained through a review of medical records, anamnesis, and imaging methods such as theloscopy and ultrasonography. Histopathological analysis provided a definitive diagnosis.(AU)

Relata-se a ocorrência de um caso incomum de fibrose obstrutiva do anel venoso de Fürstenberg em quatro quartos mamários de uma vaca da raça Girolando (3/8 Gir e 5/8 Holandês). As informações foram obtidas por meio de revisão do prontuário, da anamnese e de métodos de diagnóstico por imagem, como a teloscopia e a ultrassonografia. A análise histopatológica forneceu o diagnóstico definitivo.(AU)

Intraventricular pneumocephalus associated with nasocephalic necrosis in a puppy: a case report / Pneumoencéfalo intraventricular associado à área de necrose nasoencefálica em filhote canino: relato de caso

Pneumocephalus is defined as the presence of air in any of the intracranial compartments. Its most frequent causes are trauma and cranial surgery. Clinical signs occur as a result of increased intracranial pressure and vary with the location and extent of the lesion. A case involving a seven-month-old female Saint Bernard, who suffered cranial trauma caused by a bite to the face at ten days of age and had presented with seizures and localized pain four months previously is reported. A computed tomography scan of the skull revealed a nasocephalic mass with low contrast enhancement, bone lysis, and hypodensity (-940 Hounsfield units) of the lateral and third ventricles, indicating intraventricular pneumocephalus. During surgery, a fragment of the mass was collected for histopathological examination, which demonstrated the presence of multifocal areas of necrosis. The computed tomography (CT) is a reliable method for the characterization of intracranial lesions and diagnosis of pneumocephalus, whose occurrence must be considered in pathological processes in which there is increased intracranial pressure and in patients undergoing certain surgical procedures and anesthetic specific, and CT is indicated as a monitoring tool for these patients.(AU)

Pneumoencéfalo é definido como a presença de gás em quaisquer dos compartimentos intracranianos e possui como causas mais frequentes o traumatismo e cirurgias cranianas. Os sinais clínicos ocorrem como consequência do aumento de pressão intracraniana e variam conforme o local e a extensão da lesão. Relata-se o caso de uma cadela de sete meses de idade, da raça São Bernardo, que sofreu trauma por mordedura em face, quatro meses antes, apresentando crises convulsivas e sensibilidade dolorosa local desde então. O exame tomográfico do crânio revelou massa nasoencefálica com baixa captação de contraste, lise óssea e hipodensidade (-940HU) dos ventrículos laterais e terceiro ventrículo encefálico, caracterizando pneumoencéfalo intraventricular. Foi realizada intervenção cirúrgica e coleta de fragmento da massa para exame histopatológico, que demonstrou existência de necrose multifocal. O exame de tomografia computadorizada (TC) é um método confiável para a caracterização de lesões intracranianas e diagnóstico de pneumoencéfalo, cuja ocorrência deve ser considerada em processos patológicos nos quais há aumento da pressão intracraniana e em pacientes submetidos a alguns procedimentos cirúrgicos e anestésicos específicos, sendo a TC indicada como ferramenta de monitoramento desses pacientes.(AU)

Intraventricular pneumocephalus associated with nasocephalic necrosis in a puppy: a case report / Pneumoencéfalo intraventricular associado à área de necrose nasoencefálica em filhote canino: relato de caso

Pneumocephalus is defined as the presence of air in any of the intracranial compartments. Its most frequent causes are trauma and cranial surgery. Clinical signs occur as a result of increased intracranial pressure and vary with the location and extent of the lesion. A case involving a seven-month-old female Saint Bernard, who suffered cranial trauma caused by a bite to the face at ten days of age and had presented with seizures and localized pain four months previously is reported. A computed tomography scan of the skull revealed a nasocephalic mass with low contrast enhancement, bone lysis, and hypodensity (-940 Hounsfield units) of the lateral and third ventricles, indicating intraventricular pneumocephalus. During surgery, a fragment of the mass was collected for histopathological examination, which demonstrated the presence of multifocal areas of necrosis. The computed tomography (CT) is a reliable method for the characterization of intracranial lesions and diagnosis of pneumocephalus, whose occurrence must be considered in pathological processes in which there is increased intracranial pressure and in patients undergoing certain surgical procedures and anesthetic specific, and CT is indicated as a monitoring tool for these patients.

Pneumoencéfalo é definido como a presença de gás em quaisquer dos compartimentos intracranianos e possui como causas mais frequentes o traumatismo e cirurgias cranianas. Os sinais clínicos ocorrem como consequência do aumento de pressão intracraniana e variam conforme o local e a extensão da lesão. Relata-se o caso de uma cadela de sete meses de idade, da raça São Bernardo, que sofreu trauma por mordedura em face, quatro meses antes, apresentando crises convulsivas e sensibilidade dolorosa local desde então. O exame tomográfico do crânio revelou massa nasoencefálica com baixa captação de contraste, lise óssea e hipodensidade (-940HU) dos ventrículos laterais e terceiro ventrículo encefálico, caracterizando pneumoencéfalo intraventricular. Foi realizada intervenção cirúrgica e coleta de fragmento da massa para exame histopatológico, que demonstrou existência de necrose multifocal. O exame de tomografia computadorizada (TC) é um método confiável para a caracterização de lesões intracranianas e diagnóstico de pneumoencéfalo, cuja ocorrência deve ser considerada em processos patológicos nos quais há aumento da pressão intracraniana e em pacientes submetidos a alguns procedimentos cirúrgicos e anestésicos específicos, sendo a TC indicada como ferramenta de monitoramento desses pacientes.

Morgan line and its relationship with distraction index, angle of inclination and degenerative joint disease in the diagnosis of canine hip dysplasia / Linha Morgan e sua relação com índice de distração, ângulo de inclinação e doença articular degenerativa no diagnóstico da displasia coxofemoral canina

We evaluated 160 hip joint radiographs of 40 dogs of different large breeds (25 females and 15 males) from the metropolitan area of Belo Horizonte, Minas Gerais, Brazil. The radiographs of each dog were obtained at two different stages: stage 1 (mean 7.23 months) and stage 2 (mean 14.25). The conventional radiographic method (CRM) and the radiographic distraction method (RDM) were used, carried out in both stages. CRM measured the Norberg angle (NA), the angle of inclination (AI) and evaluated the presence of degenerative joint disease (DJD). The MRD was performed to establish the distraction index (DI). The aims were to evaluate the presence of the Morgan line and other signs of DJD and correlate them with the degree of canine hip dysplasia (CHD) and also check if the DI greater than 0.3 (first stage) was associated with the presence of ML (second stage). It was found that DI, AI and changes of femoral neck and the formation of osteophytes were associated with the presence of ML. It was observed that if the DI is greater than 0.3 at the first stage, the chance of a positive outcome of ML in the second stage increases by 7.2 times. Thus, 49 joints showed DI > 0.3 at the first stage, in which 31 (63.3 %) presented ML at the second stage. Of the 31 animals that showed DI ≤ 0.3 at first, six (19.4%) had LM at the second stage. There has been a significant association between the presence of ML and the degree of CHD. The more severe the CHD, the higher the percentage of positive ML results. Thus, among the 24 (60 %) animals that showed ML, 11 (45.83 %) were classified as severe dysplastics, 5 (20.83%) as moderate and 8 (33.33 %) as mild. None of the animals classified as normal or borderline presented ML. Among the 8 animals classified as mild dysplastics, 5 showed only ML as DJD.(AU)

Avaliaram-se 160 radiografias das articulações coxofemorais de 40 cães de diferentes raças de grande porte, provenientes de Belo Horizonte, Brasil. As radiografias de cada animal foram obtidas em dois momentos: um (média de 7,23 meses de idade) e dois (média de 14,25 meses). Utilizaram-se o método radiográfico convencional (MRC) e o método radiográfico em distração (MRD), ambos realizados nos dois momentos. No MRC, mensurou-se o ângulo de Norberg (AN), o ângulo de inclinação (AI) e avaliou-se a presença de doença articular degenerativa (DAD). O MRD foi realizado para se estabelecer o índice de distração (ID). Os objetivos foram avaliar a presença da linha Morgan (LM) e de outros sinais de DAD, correlacionando-os com o grau de displasia coxofemoral (DCF); além de se verificar se o ID maior que 0,3 (primeiro momento) possui associação com a presença de LM (segundo momento). Verificou-se que ID, AI e encurtamento e/ou espessamento do colo femoral e formação de osteófitos foram associados à presença da LM. Observou-se que, quando o ID era maior que 0,3 no primeiro momento, a chance de um resultado positivo da LM no segundo momento aumentava em 7,2 vezes. No primeiro momento, 49 articulações apresentaram ID > 0,3. Destas, 31 (63,3%) apresentaram LM no segundo momento. Dos 31 animais que apresentaram ID ≤ 0,3 no primeiro momento, seis (19,4%) desenvolveram LM no segundo momento. Houve associação significativa entre presença de LM com o grau de DCF, e quanto mais grave a DCF, maior foi o percentual de resultados positivos da LM. Dos 24 (60%) animais que apresentaram LM, 11 (45,83%) foram classificados como displásicos graves, cinco (20,83%) como médios e oito (33,33%) como leves. Nenhum dos animais considerados suspeitos ou normais apresentou LM. Dos oito animais classificados como displásicos leves, cinco apresentaram apenas LM como sinal de DAD.(AU)

Parâmetros radiográficos de displasia coxofemoral na raça Rottweiler / Radiographic parameters of hip dysplasia in Rottweilers

In this study, 139 radiographs of the Rottweiller breed dog, 44 males and 95 females were evaluated. Radiographs were classified by the degree of hip dysplasia, and we measured the angle of inclination, Norberg angle, the cortical index and percentage of coverage of the femoral head on both sides. The aim of this study was to evaluate that parameters based on gender and age of animals correlating them with the incidence and severity of hip dysplasia. In dysplastic dogs the mean Norberg angle was 100.09 ± 7.86 °, the mean percent coverage of the femoral head was 41.50 ± 8.59%, the mean femoral cortical index was 0.33 ± 0.04, and the femoral angle mean was 153.06 ± 9.81 °. Higher inclination angles were associated with smaller angles of Norberg and lowest percentage of coverage of the femoral head. In this study gender, cortical index and angle of inclination did not show any association with the DCF.(AU)

Estudo radiográfico da articulação lombossacra em cães das raças Pastor Alemão, Rottweiler e Doberman / Radiographic study of the lumbosacral joint in German Shepherd, Rottweiler and Doberman dogs

Este trabalho teve como objetivo avaliar a variação entre diferentes raças das medidas radiográficas da articulação lombossacra. Foram utilizados 20 cães da raça Pastor Alemão, 20 cães da raça Rottweiler e 20 da raça Doberman. A articulação lombossacra foi avaliada radiograficamente com os membros pélvicos em posição neutra (N), em ventroflexão (VF) e dorsoextensão (DE). Foram mensurados os ângulos entre os processos articulares de L7 e S1 (PA), entre as epífises distal de L7 e proximal de S1 (EPIF), o ângulo lombossacro (LS), a amplitude de movimento (ROM) desses ângulos, o ponto de interseção das retas que formam esses ângulos e a respectiva ROM. Os resultados mostraram que a altura do canal vertebral em L7 é menor no Pastor Alemão (9,5mm) e maior no Rottweiler (10,5mm). O EPIF-DE foi maior no Pastor Alemão (38,03º). O PA-N foi menor no Pastor Alemão (15,98º). O LS-VF foi menor no Doberman (170,01º), e não diferiu entre o Pastor Alemão (179,17º) e o Rottweiler (176,61º). Os cães Pastores Alemães demonstraram uma maior ROM dos ângulos EPIF e LS. Concluiu-se que cães da raça Pastor Alemão apresentam maior instabilidade dessa articulação em relação às outras duas raças estudadas.(AU)

The purpose of this work was to evaluate the racial difference of radiographic measurements of canine lumbosacral joints.20 German Shepherd, 20 Rottweiler and 20 Doberman dogs were used in the study. The lumbosacral joint was assessed radiographically with the hind limbs in neutral position (N), in ventral flexion (VF) and dorsal extension (DE). We measured the angles between the L7 and S1 articular processes (PA), between the distal L7 and S1 proximal epiphysis (EPIF), the lumbosacral angle (LS), range of motion (ROM) of these angles, the intersection point of the lines that form these angles and their ROM. The results show that the height of the spinal canal in L7 is lower in German Shepherds (9.5mm) than in Dobermans (10mm) and Rottweilers (10.5 mm). The EPIF-DE was higher in the German Shepherd (38.03°). The PA-N was lower in German Shepherd (15.98 °). The LS-VF was lower in the Doberman (170.01°), and LS did not differ statistically between German Shepherd (179.17°) and Rottweiler (176.61°). The ROM of the LS and EPIF angles were greater in the German Shepherd dogs. It was concluded that the German Shepherd dogs have radiographic measurements that lead to greater instability of the lumbosacral joint.(AU)

Avaliação radiográfica da diplasia coxofemoral de cães adultos: comparação entre dois métodos / Evaluation of radiographic hip dysplasia in adult dogs: comparison between two methods

O objetivo deste estudo foi comparar a eficiência dos métodos radiográficos convencional e em distração de cães da raça Pastor Alemão adultos. Foram utilizados 16 animais, sendo onze fêmeas e oito machos, com idade média de quatro anos e dez meses. Todos os cães participantes foram avaliados clinicamente para se detectar a presença de alterações relacionadas ao aparelho locomotor e/ou sistema nervoso que afetariam a locomoção normal do cão, excluindo-se as alterações clínicas decorrentes do quadro de displasia coxofemoral (DCF). Para avaliação radiográfica das articulações coxofemorais, foram realizadas duas técnicas de avaliação, o Método Radiográfico Convencional (MRC), adotado pela Fédération Cynologique Internationale, e o Método Radiográfico em Distração (MRD). Dos animais avaliados, 62,5% foram classificados com algum grau de DCF. A correlação entre o MRC e o MRD foi moderada e a utilização isolada do MRD, pouco eficaz, com sensibilidade de 75% e especificidade de 44%. Nas condições em que este experimento foi conduzido, pode-se concluir que o MRC é um exame eficaz no diagnóstico quando comparado ao MRD em cães da raça Pastor Alemão adultos...

The aim of this study was to compare the efficacy of conventional and distraction radiographic methods in adult German Shepherd dogs. Sixteen animals were tested, eleven females and eight males, with a mean age of 4.8 years. All dogs were clinically evaluated to detect locomotor and/or nervous system changes that could affect normal locomotion, but clinical hip dysplasia (HD) alterations were excluded. Two techniques were used for radiographic evaluation of hip joints, the Conventional Radiographic Method (CRM), adopted by Fédération Cynologique Internationale and the Distraction Radiographic Method (DRM). 62.5% of the evaluated animals were classified as having some degree of HD. The correlation between CRM and DRM was moderate. When DRM was used alone, it was considered an ineffective method, with 75% sensitivity and 44% specificity. From this study, it can be concluded that CRM is an effective diagnostic method for hip dysplasia when compared to DRM in adult German Shepherd dogs...

Antinociceptive and antiedematogenic properties and acute toxicity of Tabebuia avellanedae Lor. ex Griseb. inner bark aqueous extract.

BACKGROUND: Tabebuia avellanedae is a tree from the Bignoniaceae family. Commonly know as "pau d'arco" in Brazil, its inner bark is used as analgesic, anti-inflammatory, antineoplasic and diuretic at the Brazilian northeast. A validation of the plant usage has not been previously performed. RESULTS: Antinociceptive and antiedematogenic effects of Tabebuia avellanedae Lor. ex Griseb. inner bark were measured by nociceptive experimental models in mice. A rat paw edema test induced by carrageenan (1%) was also performed in rats to access the plant's antiedematogenic effect. The inner bark aqueous extract, administered via oral in three different concentration, namely 100, 200 and 400 mg/Kg, reduced the nociception produced by acetic acid (0.6% in water, i.p.) by 49.9%, 63.7% and 43.8%, respectively. The aqueous extract (200 and 400 mg/Kg, p.o.) reduced formalin (1%) effects only at the second phase of the experiment by 49.3% and 53.7%, respectively. Naloxone (5 mg/Kg, i.p.) was not able to revert the extract effect, however caffeine (10 mg/Kg, i.p.) reverted its effect by 19.8% at the second phase of the formalin test. The aqueous extract (200 mg/Kg, p.o.) inhibited edema by 12.9% when we used the rat paw edema model. The acute toxicity was low in mice. CONCLUSION: The T. avellanedae inner bark aqueous extract presented antinociceptive and antiedematogenic activities at the used models, with a possible antinociceptive effect associated to the adenosine system.

[Lead poisoning caused by a bullet in the hip. Report of 2 cases]. / Saturnismo causado por projétil de arma de fogo no quadril. Relato de dois casos.

Two cases of lead poisoning from retained bullets in the hip region are reported. General considerations about lead intoxication are made and the intoxication caused by bullets retained in the body are specifically focused.

Nova prótese articulada de quadril / A new articulated prosthesis of the hip

Conceberam-se uma nova prótese articulada para o quadril, com a finalidade de ser usada nos casos de grandes extirpaçöes ósseas proximais do fêmur, por tumor ou outra causa. A nova prótese foi utilizada em 10 casos, dos quais foram avaliados 9, pois um dos pacientes faleceu por embolia pulmonar no 7§ dia de pós-operatório. Nos 9 casos, o resultado foi bom quanto à recuperaçäo do andar, possibilitando melhores condiçöes de vida aos doentes atingidos por graves lesöes tumorais, quando, após a ressecçäo óssea, faltava a contensäo dada pela musculatura que havia sido lesada ou perdido os seus pontos de inserçäo

Abnormal cerebrovascular responses to CO2 in sleep apnea patients.

The responses of common carotid blood flow (CCF), pressure (BP), and resistance (R) to variations in respiratory gases were compared during waking periods in 10 sleep apnea patients (SA) and 10 healthy controls (N) of similar age. Respiratory gases were altered by 3-min CO2 rebreathing (RB), 3-min hyperventilation (HV), and 4-min hypoxia (HYP) procedures. CCF was measured continuously by a 5-MHz pulsed Doppler duplex scanner and R was calculated using brachial BP. During RB, which increased end-tidal PCO2 (PACO2) by 15 mm Hg, SA had a lower CCF and greater BP response and therefore a significantly different (positive) change in R compared with N. The ventilatory responses to CO2 were not significantly different. With HV the PACO2 fell by 13 mm Hg in both groups and CCF fell more markedly in SA than N with the same change in BP; therefore, R was increased significantly more in SA. The HYP results did not demonstrate a difference between groups. These results suggest that abnormal cerebrovascular responses to PACO2, initiated either by unusual vasoactive properties of cerebral resistance vessels or peculiar venous outlow patterns, may initiate or potentiate periodic breathing in SA by prolonging lung-to-brain circulation time.

Luxacao escapulo-umeral recidivante.(L.R.E.U.) tratamento pela osteotomia do colo escapular.(Revisao e apresentacao de 20 casos). / Recurrent dislocation of the shoulder. Treatment by osteotomy of the glenoyd. (Review and report of 20 cases)

Os autores historiam sucintamente as tecnicas de tratamento cirurgico da luxacao escapulo-umeral. Descrevem a tecnica de Bittar e comentam os resultados de 20 casos operados no Hospital da Beneficiencia Portuguesa de Sao Paulo,que aumentam a casuistica do metodo usado ha 25 anos

Quantitative evaluation of atherosclerosis using Doppler ultrasound.

During the last two decades, various Doppler methods have been successfully used to screen patients with significant cerebral and peripheral vascular disease. In general terms, the principal advantages of Doppler ultrasound techniques in the evaluation of atherosclerotic lesions are that they: 1) are noninvasive, 2) are nontraumatic, 3) are relatively inexpensive, 4) provide anatomical and physiological data, and 5) provide direct and dynamic measurements. Nevertheless, the general limitations of the techniques are of equal importance: 1) the techniques are difficult in some subjects due to obesity and anatomical variations; 2) the technique cannot examine tissues surrounded by air or bone; 3) the techniques require operator skill and a thorough knowledge of human anatomy and cardiovascular dynamics; 4) the techniques have finite spatial resolutions which may compromise the important measurement of vessel diameter, ulceration, and percent stenosis; and 5) the techniques have finite velocity measuring capabilities which may compromise some measurements of highly disturbed blood velocities outside the range of 2-200 cm/sec. As clinical demands for the early diagnosis and quantification of vascular lesions increased, improvements in Doppler ultrasonics and spectra analysis significantly increased the technical and clinical capabilities of existing simple, inexpensive instruments. Presently, both anatomical and physiological images along with quantitative Doppler spectra from superficial and deep-lying vessels can be obtained. Consequently, the ability of new expensive imaging equipment to quantitate atherosclerotic lesions using spectral analysis techniques compares favorably with the interpretational precision of standard invasive or intravenous digital angiography.

Fratura inusitada da tibia. (Relato de um caso). / Unusual fracture of the tibia. (Report of a case)

Os A.A. descrevem um caso incomum de fratura fechada da extremidade distal da tibia com migracao a distancia de um fragmento osseo intermediario. Comentam a evolucao e os possiveis mecanismos de producao da lesao, que referem nao terem encontrado similar descrito na literatura

Organized cerebral heterotopia in the ethmoid sinus. A case report.

A 60-year-old woman afflicted with spontaneous CSF rhinorrhea was found to have a heterotopia consisting of well-differentiated neurons organized in layers in the lamina propria of the mucosa of the ethmoid sinus. This heterotopic cerebral anlage is best classified within the spectrum of "nasal gliomas". The origin of this malformation is a failure of closure of the anterior neuropore which delays the ingrowth of the mesoderm that is destined to form the skull and dura beyond the 10th week of gestation, leaving behind trapped cerebral tissue. The presentation of this congenital malformation late in life is attributed to the development of sinusitis.