顳葉腦膜腦膨出併急性細菌性腦膜炎

Temporal Meningoencephalocele Complicated with Acute Bacterial Meningitis

廖淑娟(Shu-Chen Liao) ； 葉建宏(Jiann-Horng Yeh) ； 蔡明達(Ming-Dar Tsai) ； 李進成(Chin-Cheng Lee) ； 蔡裕豐(Yuh-Feng Tsai)

《台灣醫學》 11卷1期 (2007/01) Pp. 29-33

https://doi.org/10.6320/FJM.2007.11(1).05

摘要

腦脊髓液鼻漏(CSF rhinorrhea)合併急性細菌性腦膜炎(acute bacterial meningitis)大多由外傷和手術引起，而由顱底結構異常所造成是屬於比較少見的。本文報告一位51歲女性病人發生腦脊髓液鼻漏合併急性細菌性腦膜炎，磁振造影發現左側顳葉有一軟組織腫塊延伸膨岀至蝶竇(sphenoid sinus)內，蝶竇內並有液體堆積，推測此處有腦脊髓液洩漏，因此立即安排手術，檢體經病理檢查確定為腦膜腦膨出；病人經藥物及外科治療後治癒。因此，在發現病人單側鼻孔間歇性流出清澈鼻液，尤其頭低下更明顯，且合併發燒時，需排除腦脊髓液鼻漏及造成腦膜炎的可能性，並要找出潛在的顱底結構缺陷，以期達到正確的早期診斷與治療。

關鍵字

腦膜腦膨出 ； 腦脊髓液鼻漏 ； 急性細菌性腦膜炎

並列摘要

Trauma and surgery are the most common causes of CSF rhinorrhea. Malformations such as menigocele, or meningoencephalocele, arachnoidal cysts, empty sella syndrome, hydrocephalus, and bony dehiscences along the skull base can be responsible for 3% to 4% of the cases in which CSF rhinorrhea occurs spontaneously. We report a case of CSF rhinorrhea complicated with acute bacterial meningitis. An MRI showed a soft tissue mass in the left mesial temporal lobe infiltrating the adjacent sphenoid sinus. She then received operation and a transphnoidal biopsy proved a meningoencephalocele. Miningoencephalocele is an uncommon malformation responsible for CSF leakage and resultant acute bacterial meningitis. Causes for possible occult anatomical defect in the skull base should be sought for patients with complicated CSF rhinorrhea.

並列關鍵字

meningoencephalocele ； CSF rhinorrhea ； acute bacterial meningitis