CASE REPORT
Delayed Diagnosis of Post-traumatic Temporal Lobe Meningo Encephalocele: A Rare Case Report of a Child
Zahra Sadr1, *, Samileh Noorbakhsh2, Yaser Nasoori3
Article Information
Identifiers and Pagination:
Year: 2023Volume: 17
E-location ID: e1874205X245559
Publisher ID: e1874205X245559
DOI: 10.2174/011874205X245559231002050223
Article History:
Received Date: 11/02/2023Revision Received Date: 25/06/2023
Acceptance Date: 04/08/2023
Electronic publication date: 1/11/2023
Collection year: 2023
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction:
Bone fracture after head trauma is common in children. When a fracture happens in the temporal bone, Cerebrospinal fluid (CSF) might leak and/or the temporal lobe protrude (named encephalocele) as a mass inside the middle ear or mastoid or both.
Case Presentation:
Here, a 10 year old presents with an initial diagnosis of bacterial meningitis. Three years ago after head trauma he had a forgotten bone fracture. Incomplete improvement after primary treatment was achieved. Finally, after seeing a bone fracture on the right roof of the tympani and soft tissue mass in brain High-Resolution Compound Tomography (HRCT),surgical exploration determined the CSF leakage from a right lobe temporal meningo encephalocele. The bone defect was repaired and the patient had complete improvement.
Conclusion:
In this case with forgotten post traumatic temporal bone fracture, temporal bone encephaloceles lead to CSF leakage inside the middle ear cavity and introduce bacterial meningitis. High-Resolution Compound Tomography (HRCT) of the cranial base defined the bone defect. In recent years, Magnetic Resonance Imaging(MRI) has been known as the best method for the diagnosis of brain tissue herniation in the middle ear cavity. Although to differentiate the encephalocele from other masses (e.g. granulation, cholesteatoma, cholesterol granuloma, etc.) inside the middle ear cavity in an MRI is not easy. Surgical multilayered closure of the dura and simultaneous repair of the bone defect is needed.
