Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

Jalessi, Maryam; Jahanbakhshi, Amin; Sharifi, Guive; Azar, Jila Mohammadi; Farhadi, Mohammad; Mobasseri, Alireza

doi:10.1016/j.inat.2015.02.002

Cited by 5 publications

(2 citation statements)

References 10 publications

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“… 17 , 19 , 20 It also has the benefit of removing the mucosa adherent to the wall of the sac, preventing mucocoele formation cephalad to the site of reconstruction. 21 This tissue is also potentially epileptogenic. 22 …”

Section: Discussionmentioning

confidence: 99%

Transsphenoidal meningoencephalocele protruding into the nasal cavity

et al. 2017

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Spontaneous transsphenoidal meningoencephalcele is a rare entity, even rarer through the Sternberg’s canal, a congenital defect on the lateral wall of the sphenoid sinus. We report such a case in an obese 52-year-old female with spontaneous cerebrospinal fluid (CSF) rhinorrhoea and recurrent meningitis. Brain CT, MRI and CT cisternography were performed. Surgical correction and short-term follow-up were recorded. CT scan showed a defect on the lateral wall of the right sphenoid sinus filled with a soft tissue mass extending to the nasal cavity. MRI scan revealed brain parenchyma from the right temporal lobe herniated through the sphenoid bone defect. CT cisternography showed 270 mmH2O opening pressure and confirmed the CSF leakage. Surgical correction was performed with resolution of the symptoms. MRI and CT are complementary modalities for evaluating this entity, the first being the method of choice for meningoencephalcele diagnosis although bone defects are best depicted on CT scan. CT cisternography identifies the specific site of leak and confirms benign intracranial hypertension, consistently reported in meningoencephaloceles. Obesity and benign intracranial hypertension have been reported as a combined mechanism allegedly contributing to meningoencephaloceles through congenital skull base defects, by increasing intraabdominal pressure thus decreasing venous return, with augmented intracranial pressure and subsequent reduced absorption of the CSF.

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Section: Discussionmentioning

confidence: 99%

Transsphenoidal meningoencephalocele protruding into the nasal cavity

et al. 2017

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“…Other uncommon types of basal encephaloceles include sphenopharyngeal, spheno-orbital, sphenomaxillary, sphenoethmoidal, transethmoidal, trans-sphenoidal or basioccipital [2]. There have been very few case reports about spheno-orbital, transethmoidal and trans-sphenoidal [4] basal encephaloceles and meningoencephaloceles, but many cases of posterior convexity occipital encephaloceles which are associated with Chiari III malformation. A thorough literature search revealed a case report by Martinez et al [5] of recurrent meningitis in an infant due to a clival defect with meningocele.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Basioccipital Encephalomeningocele with Tethered Dermoid Presenting as Cranial Nerve Palsy: A Case Report

Jaganmohan

Nagarajan²,

Ananthakrishnan³

et al. 2016

Pediatr Neurosurg

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Spontaneous transethmoidal meningoencephalocele presenting in the form of recurrent unilateral nasal discharge: discussion of the diagnosis and endoscopic surgical management

et al. 2020

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Meningoencephaloceles of the skull base most commonly occur as a sequela of head trauma or they can more rarely be congenital malformations. Several types of encephalocele exist depending on anatomic features and localisation. Clinical presentation and symptoms can vary. Different methods of management and repair of the concurring skull base defects have been described and ranging vary from endoscopic to open surgical approaches. We report the case of a 56-year-old Caucasian woman with the diagnosis of right sided spontaneous transethmoidal meninoencephalocele. Clinical presentation of this rare pathology, methods of diagnostic and management and its outcome are presented. Spontaneous skull base meningoencephaloceles are rare entities, without clear underlying etiologies. Multidisciplinary management is recommended. The transnasal endoscopic approach provides a wide skull base exposure with more advantages and less morbidity in comparison with the conventional open approach.

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Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

Cited by 5 publications

References 10 publications

Transsphenoidal meningoencephalocele protruding into the nasal cavity

Transsphenoidal meningoencephalocele protruding into the nasal cavity

A Rare Case of Basioccipital Encephalomeningocele with Tethered Dermoid Presenting as Cranial Nerve Palsy: A Case Report

Spontaneous transethmoidal meningoencephalocele presenting in the form of recurrent unilateral nasal discharge: discussion of the diagnosis and endoscopic surgical management

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