Idiopathic Temporal Bone Meningoencephalocele – A Case Report
Year: 2025
Type: article
Study design: Case Report
Abstract: Aim: To present a clinical case of idiopathic meningoencephalocele of the temporal bone and review relevant literature.Background: Meningoencephalocele of the temporal bone is a rare and potentially life-threatening condition with multiple etiologies: infectious, traumatic, iatrogenic, neoplastic, and congenital. Its diagnosis is challenging, and it can present as simple serous otitis media or manifest with more severe symptoms such as meningitis, cerebral abscess, and temporal headaches.Case Description: A 52-year-old obese, hypertensive woman, with a history of two prior episodes of meningitis and right serous otitis media under ENT care, presented to the Emergency Room (ER) with right ear pain, weakness, gaze deviation, and incontinence. A computerized tomography (CT) scan showed lateral opacification of the mastoid air cells and chronic rhinosinusitis and lumbar puncture confirmed meningitis. MRI suggested cranial floor dehiscence with a possible meningoencephalocele. The patient underwent mastoidectomy with reduction of herniated tissue and closure of the fistula via a retroauricular approach. The patient remains well during a 9-month follow-up.Conclusion and Clinical Significance: Spontaneous meningoencephaloceles of the temporal bone are associated, although without proven cause-effect relationship, with aberrant arachnoid granulations and idiopathic intracranial hypertension, especially in middle-aged obese women. Surgical treatment is required, and depending on the size of the fistula, repair can be approached through the middle fossa, transmastoid, or combined approaches. Multilayered correction is crucial for better surgical outcomes, regardless of the extent of the defect.
Source: acta
Institution: Hospital Garcia de Orta
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220148556