Recurrent Meningitis in a Child with Transethmoidal Meningoencephalocele

Abstract

Encephalocele is a very rare congenital anomaly. This anomaly is classified into two subtypes; transeth-moidal and transsphenoidal. The transethmoidal type is the most commonly observed. Transethmoidal meningoencephalocele (TEME) is a very rarely encountered congenital malformation characterized by a protrusion of cerebral tissue and meninges through a congenital defect in the cranial bones. The occult types have no external manifestations and are therefore only discovered when complications arise. These are most commonly recurrent meningitis and cerebrospinal fluid (CSF) rhinorrhea. In this report, a 14-year-old girl with recurrent bacterial meningitis due to TEME, is presented. She had suffered from four episodes of recurrent bacterial meningitis for the last two years. The patient did not have any symptoms of cerebrospinal fluid leakage. Computed tomography images of the paranasal sinuses showed an abnormality with a bony defect at the ethmoid roof of the left paranasal sinuses. Brain magnetic resonance images demonstrated the left TEME transeth-moidal meningoencephalocele protruding into the ethmoidal sinus. In conclusion, TEME should be considered in patients with recurrent bacterial meningitis.