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Nasopharyngeal glial heterotopia with delayed postoperative meningitis
Kenichi Maeda1, Kenji Furuno1, Pin Fee Chong2
1Department of General Pediatrics & Interdisciplinary Medicine, Fukuoka Children's Hospital, Fukuoka, Japan.
BMJ Case Reports
|June 25, 2017
Summary
Delayed bacterial meningitis in an infant was linked to a rare brain malformation. Intracranial and extracranial connections allowed infection spread, highlighting risks of hypothalamic hamartoma.
Area of Science:
- Neuroscience
- Pediatric Neurosurgery
- Infectious Diseases
Background:
- Glial heterotopia is a rare congenital brain malformation.
- Nasopharyngeal glial heterotopia requires surgical resection in infants.
- Postoperative complications like meningitis can occur.
Observation:
- A male infant underwent resection of nasopharyngeal glial heterotopia at 8 days old.
- At 9 months, the infant developed delayed bacterial meningitis.
- Neuroradiology revealed intracranial and extracranial connections facilitating infection.
Findings:
- The meningitis resulted from a transsphenoidal extension of hypothalamic hamartoma.
- The connection originated from the right optic nerve, traversing the sphenoid bone.
- This pathway led to a recurrent mass in the nasopharyngeal region.
Implications:
- This case highlights the potential for delayed meningitis due to subtle intracranial-extracranial connections.
- Early and thorough neuroradiological assessment is crucial for identifying such pathways.
- Understanding these connections is vital for managing pediatric neurosurgical cases involving brain malformations.
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