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Review
. 2019 Mar 5;13(1):62.
doi: 10.1186/s13256-018-1959-6.

Idiopathic intracranial hypertension presenting as bilateral spontaneous lateral intrasphenoidal and transethmoidal meningoceles: a case report and review of the literature

Aleksandar Radonjic  1 , Abdul Mounem Kassab  1 , Ioana D Moldovan  2   3 , Shaun Kilty  4   1   3 , Fahad Alkherayf  5   6   7
Affiliations
Review

Idiopathic intracranial hypertension presenting as bilateral spontaneous lateral intrasphenoidal and transethmoidal meningoceles: a case report and review of the literature

Aleksandar Radonjic et al. J Med Case Rep. .

Abstract

Background: Basal meningoceles are rare herniations of the meninges that tend to present unilaterally with cerebrospinal fluid rhinorrhea. Growing evidence suggests that intracranial hypertension contributes considerably to the formation of spontaneous basal meningoceles.

Case presentation: A 50-year-old man of Middle East ethnicity presented with a 16-week history of cerebrospinal fluid rhinorrhea, short-term memory loss, and slight decline in cognitive function. We present a case of bilateral spontaneous meningoceles with bone defects in the left lateral sphenoid sinus and right anterior cribriform plate, as well as with a remodeled sella. A neuronavigation-assisted expanded endoscopic endonasal surgery was performed to resect the meningoceles. Postoperative imaging demonstrated complete resolution of the bilateral meningoceles.

Conclusions: This case reports the first bilateral basal spontaneous meningoceles in the literature. Furthermore, based on this case's imaging results and the literature reviewed, elevated intracranial pressure may be a determining factor behind the development of spontaneous meningoceles.

Keywords: Bilateral; Case report; Endonasal; Expanded endoscopic; Lateral intrasphenoidal; Meningocele; Skull base; Spontaneous; Surgery; Transethmoidal.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Computed tomography without contrast, preoperative images. a Axial and b coronal computed tomography images showed bony defects in the left lateral sphenoid sinus and right anterior cribriform plate
Fig. 2
Fig. 2
Magnetic resonance imaging cisternography, preoperative images. a and b Sagittal magnetic resonance imaging cisternography images showing right anterior ethmoidal (a) and left sphenoidal (b) meningoceles. c Axial magnetic resonance imaging cisternography image showing left sphenoidal meningocele
Fig. 3
Fig. 3
Magnetic resonance imaging without contrast, postoperative images. a Sagittal and b axial magnetic resonance imaging postoperative images showed no evidence of residual meningoceles
See this image and copyright information in PMC

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