Adult transsphenoidal meningoencephalocele: Clinical image

Encephalocele is herniation of cranial contents through a skull defect, classified according to their contents and location, and is usually seen in pediatric age group. The transsphenoidal type represents <5% of all basal meningoencephaloceles. Of them, the presentation in adulthood is even rarer.

A 19-year-old female complaining of breathing difficulties during sleep and exertional dyspnea was diagnosed with a transsphenoidal meningoencephalocele, likely representing patent craniopharyngeal canal. On exploration through bifrontal craniotomy, the defect was identified in the sellar floor after completely reducing the contents into the cranial cavity and was repaired. She had immediate symptomatic relief and an uneventful postoperative course.

There can be significant symptomatic relief with minimal postoperative morbidity after transcranial repair of such large transsphenoidal meningoencephaloceles, through traditional skull base approaches.