Brain Herniation Through the Cribriform Plate: Review and Comparison to Encephaloceles in the Same Region

Herniations of the brain and/or meninges through an opening of the skull often occur through the foramen magnum, e.g., Chiari malformations and encephaloceles. The herniation of brain matter through the cribriform plate is a rare incident and has not been reported frequently. The presence of such an occurrence still requires attention and anatomical understanding. This review will examine the potential causes of cribriform plate herniation and its distinguishability to nasal encephaloceles. The sloping of brain tissue toward potential space/opening in response to elevated pressures in the cranium to accommodate for the added pressure are features seen in herniation. The presence of a pedicle and stalk seen in an encephalocele define its characteristics, which are not visible in a 'classical' herniation. Cerebrospinal fluid (CSF) fistula commonly occurs at the cribriform plate, and due to the structural weakness, a pathway is formed. This is often seen in conjunction with meningoceles. Delineating between herniation and encephaloceles is important for both clinicians and neurosurgeons.