Overview
A meningocele is a herniation of the membranes that cover the brain (the meninges) through a defect in the skull base, while an encephalocele also contains brain tissue. When this occurs at the base of the skull near the nose and sinuses, it can be associated with a leak of cerebrospinal fluid (CSF) into the nose.
These defects can be present from birth, follow trauma or surgery, or develop spontaneously, sometimes in the setting of elevated pressure of the fluid around the brain. Because they create a connection between the nose and the space around the brain, they raise the risk of meningitis and usually need repair.
At Norelle Health, evaluation uses CT and MRI to define the defect and fluid testing to confirm a CSF leak. Many defects can be repaired endoscopically through the nose by a team that includes ENT and neurosurgical expertise, with attention to the pressure of the fluid around the brain to reduce the chance of recurrence.
Definitions
A meningocele is a pouch of the meninges (the coverings of the brain) that herniates through a defect in the skull base. An encephalocele contains brain tissue in addition to the meninges. When these occur near the nose and sinuses, they can connect the space around the brain to the nasal cavity.
Relationship to CSF rhinorrhea
Because these defects create an opening in the skull base, they are often associated with cerebrospinal fluid (CSF) leaking into the nose, known as CSF rhinorrhea. A persistent clear, watery nasal drip, especially from one side, can be a sign and should be evaluated.
Living with meningocele and encephalocele? The next step is a quiet, unhurried conversation.
Congenital, traumatic, and spontaneous causes
Encephaloceles and meningoceles may be present from birth, result from trauma or prior surgery, or develop spontaneously. Spontaneous cases are sometimes associated with elevated pressure of the fluid around the brain, which is an important factor in planning treatment.
CT/MRI and fluid testing
CT imaging shows the bony defect, while MRI demonstrates the herniated meninges or brain tissue and helps distinguish an encephalocele from other masses. If a CSF leak is suspected, laboratory testing of the nasal fluid for a specific marker can confirm it.
Endoscopic versus open repair
Many defects in this region can be repaired endoscopically through the nose, avoiding an external incision, by carefully sealing the defect and reinforcing the skull base. Open repair is reserved for selected larger or more complex defects. Repair is performed by a team with ENT and neurosurgical expertise.
Living with meningocele and encephalocele? The next step is a quiet, unhurried conversation.
Pressure evaluation and recurrence
When elevated pressure of the fluid around the brain contributes to the defect, addressing that pressure is important to reduce the chance of recurrence after repair. Follow-up confirms the repair remains durable over time.
When to seek care
Seek urgent care for persistent clear nasal drainage after head trauma or surgery, and seek emergency care for fever, severe headache, neck stiffness, or confusion, which can be signs of meningitis. These warrant immediate evaluation.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Living with meningocele and encephalocele? The next step is a quiet, unhurried conversation.
Common Symptoms
Treatment Approach
Treatment for meningocele and encephalocele is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Endoscopic repair of the skull-base defect through the nose
- 02Open repair in selected cases
- 03Evaluation and management of the pressure of the fluid around the brain
- 04Coordinated ENT and neurosurgical care
- 05Follow-up to confirm the repair is durable
Specialists who treat meningocele and encephalocele
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
Not sure who to see? Our patient coordination team can help match you with the right specialist.
(212) 444-8006Frequently Asked Questions
Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
Related Procedures
1 of 2 · Endoscopic CSF Leak Repair
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