Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.
Department of Neurology, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Neurosurg Rev. 2022 Feb;45(1):903-909. doi: 10.1007/s10143-021-01581-7. Epub 2021 Jun 18.
Cranial meningoencephalocele is a rare condition consisting of the herniation of meninges, CSF, and brain tissue through a cranial or skull base defect. Sphenoid sinus lateral recess meningoencephalocele is of particular interest due to the complex anatomy surrounding the bone defect and their demanding surgical management. In this technical note, we reported a step-by-step description of a rare case of sphenoid sinus lateral recess meningoencephalocele causing headache due to recurrent cerebrospinal fluid leak treated with a subtemporal craniotomy with extradural middle cranial fossa drilling and meningoencephalocele removal with multilayer reconstruction. The transcranial route is a safe and effective treatment for sphenoid sinus lateral recess meningoencephalocele repair. The subtemporal extradural approach allows for an optimal exposure of the relevant anatomy minimizing risks and improving the possibility to perform an effective multilayer skull base reconstruction.
颅脑膜脑膨出是一种罕见的疾病,其特征是脑膜、脑脊液和脑组织通过颅顶或颅底缺陷疝出。蝶窦侧隐窝脑膜脑膨出特别值得关注,因为骨缺损周围的解剖结构复杂,需要进行复杂的手术处理。在本技术说明中,我们报告了一例罕见的蝶窦侧隐窝脑膜脑膨出病例,该病例因反复发生脑脊液漏引起头痛,采用颞下入路开颅术,硬脑膜外中颅窝钻孔,脑膜脑膨出切除并进行多层重建。颅内外侧入路是治疗蝶窦侧隐窝脑膜脑膨出的一种安全有效的方法。颞下入路可以提供最佳的相关解剖结构暴露,最大限度地降低风险,并提高进行有效多层颅底重建的可能性。