Agaev Rasim, Gormolysova Ekaterina, Kalinovskiy Anton, Rzaev Jamil
J Neurosurg Case Lessons. 2023 Dec 25;6(26). doi: 10.3171/CASE23575.
Anomalies in the anatomical structure of the nasal cavity and paranasal sinuses often serve as a potential cause of spontaneous cerebrospinal fluid (CSF) leakage and may result in the development of a meningoencephalocele. In this report, the authors present a case of surgically treated intrasphenoidal meningoencephalocele attributed to the persistence of the lateral craniopharyngeal canal, which was further complicated by the occurrence of an intracerebral hematoma.
A temporal lobe meningoencephalocele located in the lateral recess of the sphenoid sinus was successfully managed using endoscopic endonasal transpterygoid repair (EETR). However, an intracerebral hematoma developed after resection of the meningoencephalocele, necessitating additional surgical interventions. Despite this complication, the patient exhibited a favorable clinical outcome after the surgical interventions.
This case highlights the potential risk of intracerebral hematoma associated with EETR of a lateral sphenoid sinus meningoencephalocele. A thorough examination of magnetic resonance imaging scans, especially identifying vascular structures, is crucial during surgical planning. This knowledge can help to prevent the occurrence of complications, including intracerebral hematoma.
鼻腔和鼻窦的解剖结构异常常是自发性脑脊液漏的潜在原因，并可能导致脑膜脑膨出的发生。在本报告中，作者介绍了一例经手术治疗的蝶窦内脑膜脑膨出病例，其病因是外侧颅咽管持续存在，并因脑内血肿的发生而进一步复杂化。
位于蝶窦外侧隐窝的颞叶脑膜脑膨出通过内镜鼻内经翼突入路修复术（EETR）成功治疗。然而，脑膜脑膨出切除术后发生了脑内血肿，需要额外的手术干预。尽管出现了这一并发症，但患者在手术干预后临床结果良好。
本病例突出了蝶窦外侧脑膜脑膨出的EETR相关脑内血肿的潜在风险。在手术规划过程中，对磁共振成像扫描进行全面检查，尤其是识别血管结构，至关重要。这些知识有助于预防包括脑内血肿在内的并发症的发生。
