Nasal meningoencephalocele. A clinical problem.

Four cases of nasal meningoencephalocele are reported. They demonstrate the importance of considering the diagnosis of nasal glioma or meningoencephalocele in adults with a nasal polyp of atypical appearance, or in infants with nasal obstruction and unilateral nasal polyp. Misdiagnosed and incorrectly handled patients with nasal meningoencephaloceles may develop serious ascending infections and/or a constant CSF leak. A thorough radiological examination including conventional and computerized tomography of the anterior cranial fossa, isotope cisternography and CT-cisternography is advocated. A multi-disciplinary approach is recommended in the diagnosis and treatment. The surgical procedure includes an anterior fossa craniotomy often in combination with a transnasal approach.