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Child's Nervous System

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01-07-2016 | Case Report

Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele

Authors: Byeong Ho Oh, Ok-jun Lee, Young Seok Park

Published in: Child's Nervous System | Issue 7/2016

Abstract

Introduction

Although encephalocele is a rare congenital abnormality, secondary encephalocele is extremely rare and can cause fatal complications. Here, we report a case of secondary encephalocele caused by frontal sinus wall defect due to chronic sinusitis, which was completely removed by cranialization with autologous bone graft.

Case summary

A 50-year-old man with a 10-year history of chronic sinusitis visited our hospital due to suddenly altered mentality characterized by stupor. Computerized tomography scanning and magnetic resonance imaging revealed an enlarged left frontal sinus with sinusitis. The frontal sinus cavity was calcified, and the left frontal lobe had herniated into the cavity accompanied by yellow pus. A large dural defect was also found around the frontal sinus area. After removal of the abscess and some of the frontal lobe, frontal skull base repair by cranialization was performed using autologous bone graft. Streptococcus pneumoniae was cultured from the cerebrospinal fluid (CSF), necessitating treatment with antibiotics. After the operation, the mental status of the patient improved and no CSF leakage was observed.

Discussion

In addition to correct diagnosis and early treatment including antibiotics, the surgical repair of defects is needed in patients with secondary encephalocele to prevent further episodes of meningitis. Surgical correction of frontal sinus encephalocele can be achieved through bifrontal craniotomy or endoscopic transnasal repair. If a patient has CSF leakage, open craniotomy may facilitate repair of the dural defect and allow for cranialization of the sinus.

Conclusions

Removal of dysplastic herniated brain tissue and cranialization of the frontal sinus may be a good option for treating secondary encephalocele and its associated complications, including meningitis, abscess formation, and infarction of the herniated brain parenchyma.

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Title: Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele
Authors: Byeong Ho Oh
Ok-jun Lee
Young Seok Park
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 7/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-015-3002-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele

Abstract

Introduction

Case summary

Discussion

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case summary

Discussion

Conclusions

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