Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma
A 41-year-old female patient was admitted with streptococcal meningitis on a background of 5-month history of CSF rhinorrhoea. Imaging revealed an extensive skull base lesion involving the sphenoid and ethmoid sinuses, the pituitary fossa with suprasellar extension and bony destruction. Histological...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2010/312081 |
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| author | Neil Barua David A. Hilton William Mukonoweshuro Hisham Khalil Louis Pobereskin |
| author_facet | Neil Barua David A. Hilton William Mukonoweshuro Hisham Khalil Louis Pobereskin |
| author_sort | Neil Barua |
| collection | DOAJ |
| description | A 41-year-old female patient was admitted with streptococcal meningitis on a background of 5-month history of CSF rhinorrhoea. Imaging revealed an extensive skull base lesion involving the sphenoid and ethmoid sinuses, the pituitary fossa with suprasellar extension and bony destruction. Histological examination of an endonasal transethmoidal biopsy suggested a diagnosis of olfactory neuroblastoma. A profuse CSF leak occurred and the patient developed coliform meningitis. A second endonasal endoscopic biopsy was undertaken which demonstrated the tumour to be a prolactinoma. Following endonasal repair of the CSF leak and lumbar drainage, she developed profound pneumocephalus. The patient underwent three further unsuccessful CSF leak repairs. Definitive control of the CSF leak was finally achieved through a transcranial approach with prolonged lumbar drainage. This case illustrates some of the potentially devastating complications which can occur as a consequence of complex skull base lesions. A multidisciplinary approach may be required to successfully manage such cases. |
| format | Article |
| id | doaj-art-011c5b4b13c440c88c44c7ce27783951 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-011c5b4b13c440c88c44c7ce277839512025-02-03T01:24:32ZengWileyCase Reports in Medicine1687-96271687-96352010-01-01201010.1155/2010/312081312081Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory NeuroblastomaNeil Barua0David A. Hilton1William Mukonoweshuro2Hisham Khalil3Louis Pobereskin4Department of Neurosurgery, Derriford Hospital, Plymouth PL6 5DH, UKDepartment of Neuropathology, Derriford Hospital, Plymouth PL6 5DH, UKDepartment of Neuroradiology, Derriford Hospital, Plymouth PL6 5DH, UKDepartment of Otorhinolaryngology, Derriford Hospital, Plymouth PL6 5DH, UKDepartment of Neurosurgery, Derriford Hospital, Plymouth PL6 5DH, UKA 41-year-old female patient was admitted with streptococcal meningitis on a background of 5-month history of CSF rhinorrhoea. Imaging revealed an extensive skull base lesion involving the sphenoid and ethmoid sinuses, the pituitary fossa with suprasellar extension and bony destruction. Histological examination of an endonasal transethmoidal biopsy suggested a diagnosis of olfactory neuroblastoma. A profuse CSF leak occurred and the patient developed coliform meningitis. A second endonasal endoscopic biopsy was undertaken which demonstrated the tumour to be a prolactinoma. Following endonasal repair of the CSF leak and lumbar drainage, she developed profound pneumocephalus. The patient underwent three further unsuccessful CSF leak repairs. Definitive control of the CSF leak was finally achieved through a transcranial approach with prolonged lumbar drainage. This case illustrates some of the potentially devastating complications which can occur as a consequence of complex skull base lesions. A multidisciplinary approach may be required to successfully manage such cases.http://dx.doi.org/10.1155/2010/312081 |
| spellingShingle | Neil Barua David A. Hilton William Mukonoweshuro Hisham Khalil Louis Pobereskin Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma Case Reports in Medicine |
| title | Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma |
| title_full | Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma |
| title_fullStr | Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma |
| title_full_unstemmed | Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma |
| title_short | Persistent CSF Rhinorrhoea, Pneumocephalus, and Recurrent Meningitis Following Misdiagnosis of Olfactory Neuroblastoma |
| title_sort | persistent csf rhinorrhoea pneumocephalus and recurrent meningitis following misdiagnosis of olfactory neuroblastoma |
| url | http://dx.doi.org/10.1155/2010/312081 |
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