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Primary intranasal encephalocele: a rare cause of bacterial meningitis
Abstract:
In four patients with bacterial meningitis a primary intranasal encephalocele was found as portal of entry. In two of the cases the malformation had been misdiagnosed as a nasal polyp and operated upon. In two patients a cerebrospinal fluid fistula developed spontaneously at the age of 54 years. None of the patients had associated symptoms indicating the presence of a cleft. Encephaloceles can be readily visualized by computed tomography particularly in coronal sections. The treatment of choice is transcranial surgical repair.
Insights
Intranasal encephaloceles can lead to bacterial meningitis by providing a pathway for infection. Early diagnosis via CT scans and surgical repair are crucial for effective treatment.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Bacterial meningitis can arise from unusual causes.
- Intranasal encephaloceles are rare congenital malformations.
Observation:
- Four patients presented with bacterial meningitis linked to primary intranasal encephaloceles.
- Two cases were misdiagnosed as nasal polyps and surgically treated.
- Two patients developed spontaneous cerebrospinal fluid fistulas at age 54.
Findings:
- Intranasal encephaloceles served as the entry point for meningitis.
- No associated cleft symptoms were present in these patients.
- Computed tomography, especially coronal views, effectively visualizes encephaloceles.
Implications:
- Highlights intranasal encephaloceles as a potential meningitis pathway.
- Emphasizes the importance of accurate diagnosis and imaging (CT scans).
- Recommends transcranial surgical repair as the primary treatment for encephaloceles.