Formation of a meningoencephalocele after removal of a frontal lobe meningioma by transfrontal craniotomy in a cat

Abstract

Case summary A 10-year-old castrated male domestic shorthair cat was referred for surgical treatment of a left-sided frontal lobe meningioma diagnosed by CT. Clinically, the cat had generalised tonic–clonic seizures, which reduced in frequency after treatment was started with prednisolone. After definition of the anatomical landmarks of the feline skull, a bilateral transfrontal craniotomy allowed en bloc removal of the meningioma. While postoperative recovery was uneventful, right-sided proprioceptive deficits were still present 6 months after surgery. MRI detected a probable meningoencephalocele herniating through the surgical bone defect in the frontal sinus. Because of the mild neurological deficits and good quality of life, the meningoencephalocele was not treated. Thirty-one months after meningioma removal the cat was alive without further neurological progression. Relevance and novel information To our knowledge, this is the first report to describe, in detail, the technique of transfrontal craniotomy in cats. Iatrogenic meningoencephalocele is a complication that has not previously been described after meningioma removal in cats, and should be considered as a potential complication after craniotomy.

Polysulfone tailor-made implant for the surgical correction of a frontoparietal meningoencephalocoele in a cat

“…Although MEC/MCs have been described in dogs and cats, 1 – 12 and also occasionally reported in other species, including calves, 14 – 18 pigs, 19 a rabbit 20 and a raccoon, 21 most of those animals were euthanased or treated conservatively. Medical management has been suggested for 22 dogs with MC/MEC and mild neurological signs.…”

“…Meningocoele (MC)/MEC is a relatively uncommon disease reported in companion animals, 1 – 12 and only four cases of surgical correction have been described. 1 , 8 , 10 , 11 Although a multicentric retrospective study involving 22 dogs suggested that medical management could be an option for dogs with MC/MEC and mild neurological signs, 2 surgical intervention is considered the treatment of choice in human medicine.…”

Frontal sinus repair using polymethyl methacrylate after craniectomy for a resection of a fronto‐parietal osteoma in a dog

“…The approach to lesions affecting the frontal lobes usually requires passage through the FS. This approach may result in postoperative complications in both human and veterinary medicine, such as intracranial infection, 11,12 cerebrospinal fluid leakage, 13 mucocele formation, 1–4 pneumoencephalus 6,7 or meningoencephalocele 8 . One case report describes a concomitant pneumoencephalus, herniation of the olfactory bulb and septic meningoencephalitis in a dog secondary to dorsal rhinotomy 14 .…”

“…This approach may result in postoperative complications in both human and veterinary medicine, such as intracranial infection, 11,12 cerebrospinal fluid leakage, 13 mucocele formation, 1-4 pneumoencephalus 6,7 or meningoencephalocele. 8 One case report describes a concomitant pneumoencephalus, herniation of the olfactory bulb and septic meningoencephalitis in a dog secondary to dorsal rhinotomy. 14 The FS is an air space containing microbial flora, that communicates with the nasal cavity, for this reason the frontal approaches may be associated to complications such as infections which can be potentially life-threatening.…”

“…[1][2][3][4][5] Postoperative complications after transfrontal craniotomies in dogs and cats have also been reported, such as tension pneumoencephalus 6,7 and meningoencephalocele. 8 Based on the authors' experience, infectious meningoencephalitis is also a possible complication after transfrontal craniotomies.…”