Sphenoidal meningoencephalocele associated with CSF fistula and arteriovenous malformation Spetzler-Martin V: A case report

Neurocirugia (English Edition) Pub Date : 2023-03-01 DOI:10.1016/j.neucie.2022.11.017

Esteban Ramírez-Ferrer, Rafael Aponte-Caballero, Maria Paula Aguilera-Pena, Santiago David Mendoza-Ayús, Luis Alejandro Osorio-Bohorquez, William Mauricio Riveros-Castillo

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引用次数: 1

Abstract

Cerebral Arteriovenous malformations (AVMs) are presumed congenital anomalies of the blood vessels, which can increase intracranial pressure by uncertain mechanisms.

We report the rare case of a 55-year-old male patient who complained about CSF rhinorrhea. Persisting CSF leakage prompted CT, which evidenced a bone defect in the right middle cranial fossa with protruding brain tissue. The diagnosis of a sphenoidal meningoencephalocele was made. Neuroimaging evidenced an AVM Spetzler Martin V. The lesion was targeted via an endonasal approach with resection of the herniated brain tissue and closure of the bony and dural defects. The postoperative course was uneventful without recurrence of the CSF fistula.

Documentation of these cases is essential to come up with standardized therapeutical protocols and follow-up. Nevertheless, conservative management of the AVM and surgical repair of the bone defects is an appropriate approach in the first instance, depending on the morphology and characterization of the AVM.

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Sphenoidal脑膜脑膨出伴脑脊液瘘和动静脉畸形Spetzler-Martin V一例报告

脑动静脉畸形（AVMs）被认为是先天性血管异常，其可通过不确定的机制增加颅内压。我们报告了一例罕见的55岁男性患者，他抱怨脑脊液鼻漏。持续的脑脊液渗漏促使CT检查，证实右中颅窝有骨缺损，脑组织突出。诊断为蝶窦脑膜脑膨出。神经影像学证实了AVM Spetzler-Martin V。通过鼻内入路切除突出的脑组织并闭合骨和硬膜缺损来靶向病变。术后进展顺利，无脑脊液瘘复发。对这些病例的记录对于制定标准化的治疗方案和随访至关重要。然而，根据AVM的形态和特征，AVM的保守治疗和骨缺损的外科修复首先是合适的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neurocirugia (English Edition)

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