Meningoencephaloceles occur when a small part of the brain and its protective coverings push through a weakness or defect in the skull base. This creates a pocket or sac that can extend into the nose, sinuses or ear. In simple terms it is essentially a ‘hernia’ of brain tissue into a part of the skull where it shouldn’t be. These defects can be present from birth or develop over time. They may appear suddenly after trauma, like a head injury, or be linked to a previous skull base surgery. Because they involve both the brain and the skull base, they require highly specialist assessment and treatment.
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Symptoms depend on where the defect is located and how large it is. Patients may notice a blocked or congested feeling in the nose, clear fluid leaking from the nose or ear, headaches, recurrent sinus infections, changes in hearing or a feeling of pressure in the head. In some cases, the bulging tissue can cause nasal obstruction or visible swelling inside the nose. If the defect is large or associated with a CSF leak, there may also be a risk of meningitis (read more about CSF leaks here).
There are several reasons why a meningoencephalocele may develop:
They can arise in several regions of the skull base, including:
Depending on the location, patients may experience nasal symptoms, ear symptoms or a combination of the two.
Meningoencephaloceles can occur alongside skull base tumours because tumours may erode bone, weaken the skull base or increase pressure inside the skull. Surgery to remove a tumour can also leave a small defect that later allows tissue to herniate. Even a tiny opening can cause significant symptoms or lead to a CSF leak, which increases the risk of infection.
Repairing a meningoencephalocele requires surgeons who understand the complex anatomy of the skull base, the brain, the sinuses and the inner ear. Skull Base Specialists use advanced endoscopic and microsurgical techniques to safely return the tissue to its normal position, close the defect and prevent future complications. Our team is experienced in managing both straightforward and surgically challenging cases, including recurrent defects or those associated with trauma or tumours.