Recurrent meningitis associated with a petrous apex cephalocele

Related Experiment Videos

Toshino Motojima1, Katsunori Fujii, Naruhiko Ishiwada

  • 1Department of Pediatrics, Graduate School of Medicine, Chiba University, Japan. toshino@cocoa.ocn.ne.jp

Journal of Child Neurology
|March 30, 2005
PubMed

Insights

A rare petrous apex cephalocele caused recurrent meningitis and cerebrospinal fluid (CSF) leaks in a child. Advanced imaging confirmed the diagnosis, highlighting PAC as a potential cause in pediatric cases.

Area of Science:

  • Pediatric Neurology
  • Neurosurgery
  • Radiology

Background:

  • Recurrent bacterial meningitis in children can stem from various causes.
  • Cerebrospinal fluid (CSF) leaks, such as rhinorrhea and otorrhea, are critical indicators of potential underlying pathologies.
  • Petrous apex cephalocele (PAC) is an uncommon condition typically found incidentally in adults.

Observation:

  • A 6-year-old girl presented with recurrent bacterial meningitis and CSF rhinorrhea.
  • Diagnostic imaging, including 3D CT and T2-weighted MRI, identified a petrous apex cephalocele.

Findings:

  • The petrous apex cephalocele was identified as the cause of the patient's recurrent meningitis and CSF rhinorrhea.
  • This case demonstrates that PAC, while often asymptomatic in adults, can manifest significantly in children.

Implications:

  • Petrous apex cephalocele should be considered in the differential diagnosis of pediatric patients with recurrent meningitis and CSF otorrhea or rhinorrhea.
  • Advanced imaging techniques are crucial for diagnosing PAC and its associated complications.
  • Early identification and management of PAC in children can prevent severe neurological sequelae.

Related Concept Videos

Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...