Diagnóstico clínico y tratamiento quirúrgico de un meningocele occipital / Clinical diagnosis and surgical treatment of an occipital meningocele

El meningocele occipital es una malformación congénita producida por un defecto en el cierre del tubo neural. El curso natural de esta enfermedad es hacia la muerte por infección del sistema nervioso central o hacia un grado de incapacidad motora y sensitiva avanzada. Se han descrito diversas formas clínicas de esta malformación. Su diagnóstico se basa en el examen físico y estudios imagenológicos y neurofisiológicos, indispensables para conocer el contenido del saco herniario y determinar el tipo de cirugía a realizar. Se presentó el caso de un paciente que tuvo que ser intervenido quirúrgicamente, solamente por el examen físico y el estudio radiográfico simple de cráneo, debido a la imposibilidad económica de los padres de realizar el resto de los exámenes complementarios. Se realizó apertura del saco herniario, con drenaje del líquido cefalorraquídeo y reparación de los planos musculares y cutáneos. El paciente evolucionó favorablemente.

The occipital meningocele is a congenital malformation produced by a defect in the neural tube closure. This disease's natural course is toward death caused by the infection of the central nervous system or toward some level of advanced motor or sensitive disability. There have been described several forms of this malformation. Its diagnosis is based in the physical examination and in neurophysiologic and imaging studies, indispensable to know the content of the hernia sac and to determine the kind of surgery to carry out. We presented the case of a male patient that had to be surgically treated only for the results of the physical examination and simple radiographic study, due to the economical family impossibility of paying the rest of the complementary examination. We opened the hernia sac, drained the cerebrospinal fluid and repaired the skin and muscular planes. The patient had a favorable evolution.

A Case of Encephalomeningocele Presenting with Cerebrospinal Fluid Rhinorrhea: Endoscopic Endonasal Removal with Repair / 대한이비인후과학회지

Encephalomeningocele is a rare disease presenting extracranial protrusion of the brain and meninges through the skull base defect. The authors experienced a case of cerebrospinal fluid (CSF) rhinorrhea developing from encephalomeningocele which was protruded into the nasal cavity through the cribriform plate. It was repaired successfully with septal bone and middle turbinate mucosa under nasal endoscopy. The radiologic features and techniques for the endoscopic management of meningoencephalocele with CSF rhinorrhea are discussed.