[Basal encephalocele complicated by nasal liquorrhea in patients with craniosynostosis]

The combination of basal encephalocele with craniosynostosis is a rare clinical situation. Few observations of these two pathologies combination are described in the literature. Objective: to analyze own sample of patients to determine possible causes of encephalocele formation and surgical treatment strategy.

Medical records of 4 patients with combination of encephalocele and craniosynostosis were analyzed. Data on complaints, medical history, results of medical specialists' examinations were studied. Data of CT and MRI, craniometric analysis were assessed. Obtained results were compared with literature data.

Encephalocele development in patients with craniosynostosis was secondary and related to various causes such as traumas, iatrogenic injury, intracranial hypertension. The most significant factor in occurrence and development of nasal liquorrhea relapse is increased cerebrospinal fluid pressure.

The treatment strategy for patients with basal encephalocele can be determined by the presence of intracranial hypertension and its increase after nasal liquorrhea elimination. One of the possible signs of long-lasting intracranial hypertension in children is a symptom of increased convolutional markings pattern according to the CT. If this sign is detected, it is justified to perform transcranial plastic surgery of cerebrospinal fluid-venous fistula with simultaneous reconstruction of the skull bones.