Congenital nasal meningoencephalocele in an adolescent: A case report

Intranasal meningoencephalocele is a rare condition in which the meninges and brain parenchyma protrude into the nose through a discontinuity in the base of the skull. Although it is generally a congenital anomaly, it can also occur as a result of trauma or chronic intracranial hypertension. The study of this pathology is important because it is rare, under-diagnosed and may be responsible for life-threatening neurological complications.

In this report, we present the case of a 13-year-old adolescent with a congenital transethmoidal meningoencephalocele, that went unnoticed for years, who underwent endonasal endoscopic surgery in our department, using a multilayer repair technique. We also review literature, describing the diagnostic procedures and surgical techniques used.

Nasal meningoencephalocele's pathogenesis remains poorly understood, with the most widely accepted theory being abnormal closure of the anterior neuropore. Many cases of nasal meningoencephalocele are discovered incidentally. However, it can be present in various ways. Apart from its crucial role in the diagnosis of this condition and in eliminating differential diagnoses, neuroimaging provides an essential roadmap for endoscopic surgery, which is currently the gold standard treatment. The standard treatment for meningoencephalocele is surgical excision.

A diagnosis of congenital meningoencephalocele should always be made, even in adolescence, as the symptoms may be overlooked by the patient or his or her family in the absence of complications.