Cerebrospinal Fluid Rhinorrhea due to Transethmoidal Encephalocele Following Occipital Meningioma Resection in an Adult: A Case Report

Abstract

Transethmoidal encephalocele is a rare condition in adult patients. It is usually diagnosed during childhood by cerebrospinal fluid (CSF) rhinorrhea, meningitis, a nasal mass, or seizures. We present a case of an adult woman with CSF rhinorrhea following resection of an occipital meningioma. The cribriform plate defect containing the encephalocele was diagnosed by computed tomography and magnetic resonance imaging. Transcranial surgery using a patch was performed successfully. We also discuss the possible pathophysiologic mechanisms of encephalocele and treatment options.

Keywords

rhinorrhea - encephalocele - transethmoidal

• References

• 1 David DJ. Cephaloceles: classification, pathology, and management—a review. J Craniofac Surg 1993; 4 (04) 192-202
• 2 Guion-Almeida ML, Richieri-Costa A, Saavedra D, Cohen Jr MM. Frontonasal dysplasia: analysis of 21 cases and literature review. Int J Oral Maxillofac Surg 1996; 25 (02) 91-97
• 3 Macfarlane R, Rutka JT, Armstrong D. , et al. Encephaloceles of the anterior cranial fossa. Pediatr Neurosurg 1995; 23 (03) 148-158
• 4 Nager GT. Cephaloceles. Laryngoscope 1987; 97 (01) 77-84
• 5 Kumar KK, Ganapathy K, Sumathi V, Rangachari V, Sundararajan I, Govindaraj R. Adult intranasal meningoencephalocele presenting as a nasal polyp. J Clin Neurosci 2005; 12 (05) 594-596
• 6 Mukerji SS, Parmar HA, Gujar S, Passamani P. Intranasal meningoencephalocele presenting as a nasal polyp—a case report. Clin Imaging 2011; 35 (04) 309-311
• 7 Yokota A, Matsukado Y, Fuwa I, Moroki K, Nagahiro S. Anterior basal encephalocele of the neonatal and infantile period. Neurosurgery 1986; 19 (03) 468-478
• 8 Sharifi G, Alavi E, Jalessi M, Haddadian K, Faramarzi F. Transethmoidal encephalocele after reduction of high intracranial pressure in aqueductal stenosis. Turk Neurosurg 2014; 24 (01) 75-77
• 9 Schroeder HWS, Niendorf W-R, Gaab MR. Complications of endoscopic third ventriculostomy. J Neurosurg 2002; 96 (06) 1032-1040
• 10 Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. Endoscopic endonasal repair of anterior skull base non-traumatic cerebrospinal fluid leaks, meningoceles, and encephaloceles. J Neurosurg 2010; 113 (05) 961-966
• 11 Ziade G, Hamdan AL, Homsi MT, Kazan I, Hadi U. Spontaneous transethmoidal meningoceles in adults: case series with emphasis on surgical management. ScientificWorldJournal 2016; 2016: 3238297
• 12 Tóth M, Selivanova O, Schaefer S, Mann W. Spontaneous cerebrospinal fluid rhinorrhea: a clinical and anatomical study. Laryngoscope 2010; 120 (09) 1724-1729
• 13 Harada N, Nemoto M, Miyazaki C. , et al. Basal encephalocele in an adult patient presenting with minor anomalies: a case report. J Med Case Reports 2014; 8: 24
• 14 Kubo A, Sakata K, Maegawa J, Yamamoto I. Transethmoidal meningoencephalocele in an elderly woman. Case report. Neurol Med Chir (Tokyo) 2005; 45 (06) 322-326
• 15 Schick B, Ibing R, Brors D, Draf W. Long-term study of endonasal duraplasty and review of the literature. Ann Otol Rhinol Laryngol 2001; 110 (02) 142-147
• 16 Nishizawa S, Ohta S, Yamaguchi M. Encephalocele in the ethmoid sinus presenting as a massive intracerebral hemorrhage after a “polypectomy”: a case report. Am J Otolaryngol 2005; 26 (01) 67-70
• 17 Hasegawa T, Sugeno N, Shiga Y. , et al. Transethmoidal intranasal meningoencephalocele in an adult with recurrent meningitis. J Clin Neurosci 2005; 12 (06) 702-704