title: Not the usual sinusitis.
abstract: An encephalocele is a protrusion of the cranial contents beyond the normal confines of the skull. It is a rare cause of seizure in adults. A 38-year-old woman presented with a first-onset seizure. Brain CT was interpreted as right frontal sinus opacification suggestive of sinusitis. The patient was discharged home with an amoxicillin prescription. A few days later, she was re-admitted with another seizure. Careful evaluation of the brain CT and MRI revealed a right frontal sinus posterior wall defect and possible brain encephalocele. The patient had complained of chronic nasal discharge for years and had also noticed a watery discharge from her right nostril. We suspected cerebrospinal fluid rhinorrhea. A bifrontal craniotomy was performed, the encephalocele was resected and cranialisation of the frontal sinus was completed. The patient remained free of seizures at the last follow-up.
authors.affiliation: Department of Internal Medicine, University of Texas Health Science Center, Houston, USA. hussam.m.ammar@uth.tmc.edu
authors.forename: Hussam
authors.initials: H
authors.lastname: Ammar
authors.forename: Amy
authors.initials: A
authors.lastname: Kott
authors.forename: Ragai
authors.initials: R
authors.lastname: Fouda
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000601:surgery; D003399:Craniotomy; D003937:Diagnosis, Differential; D004677:Encephalocele / Q000175:diagnosis* / Q000601:surgery; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology* / Q000601:surgery; D005260:Female; D005626:Frontal Sinus / Q000473:pathology / Q000601:surgery; D015522:Frontal Sinusitis / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed