Endoscopic treatment of traumatic basal encephaloceles: a report of 8 cases

Abstract

Long-term follow-up results demonstrated that endoscopic surgery was suitable for the treatment of traumatic basal encephaloceles. The underlay procedure is more appropriate than the overlay procedure in repairing large defects of the anterior skull base. Meticulous manipulations of the endoscope following precise autograft placement are mandatory for the successful repair of traumatic basal encephaloceles.

Imaging Diagnosis—meningoencephalitis Secondary to Suppurative Rhinitis and Meningoencephalocele Infection in a Dog

“…However, in people nasal encephaloceles can be accompanied by CSF rhinorrhea, seizures, or ascending sinonasal infection resulting in meningitis or brain abscess, especially in acquired cases. 1,8,9 In our case, CT and MRI did not have detectable imaging signs of meningoencephalitis. This lack of imaging signs is not too surprising because CT is known to be insensitive to inflammatory diseases of the central nervous system.…”

“…Many encephaloceles are due to a primary neural tube defect (i.e. congenital anomaly), but some are acquired secondary to trauma, surgical damage to the cranium, or chronically elevated intracranial pressure . Cases of congenital encephaloceles are mostly lesions in which meninges, with or without underlying brain tissue, expand dorsally, displacing the bone tissue that normally forms the roof of the cranial vault.…”

“…congenital anomaly), but some are acquired secondary to trauma, surgical damage to the cranium, or chronically elevated intracranial pressure. 5,[8][9][10] Cases of congenital encephaloceles are mostly lesions in which meninges, with or without underlying brain tissue, expand dorsally, displacing the bone tissue that normally forms the roof of the cranial vault. These can be due to failure of the neuroectoderm to separate from the overlying cutaneous ectoderm after the neural plate folds into a tube, and abnormal closure of the rostral neuropore, or can arise later due to premature or excessive enlargement of subarachnoid space or ventricles.…”

Endoscopic Management of a Traumatic Meningo-encephalocele Through a Planum Sphenoidale Defect -Case Report-

“…However, the exact limitations of endoscopic repair for meningo-encephalocele, meningocele, and encephalocele in the sphenoid sinus remain unclear, especially in terms of the size and the location of the skull base defect. 6,9,13,18) Clearly, small bone defect, small fistula, and midline location are technically easier to repair than larger and lateral defects. On the other hand, the development of endoscopic surgery has permitted the repair of large bone defects with a pediculate nasal flap, and repair of laterally located fistulae, such as in the lateral recess in the sphenoid sinus, by the transpterygoid approach.…”

“…4,16) Endoscopic repair for a meningo-encephalocele in the sphenoid sinus is a viable and less invasive alternative to conventional craniotomy, but still has technical difficulties, and indications for use are controversial even among endoscopic surgeons. 6,9,13,18) We report a case of successfully repaired CSF leakage from a traumatic meningo-encephalocele through the planum sphenoidale that was treated by endoscopic endonasal surgery.…”