Israeli doctors remove brain tissue from toddler’s nose to avert ‘catastrophe’
Parents were told mark on two-year-old’s nose was nothing to worry about; mom investigated anyway and discovered it was brain tissue and that skull needed sealing
Nathan Jeffay is The Times of Israel's health and science correspondent
An Israeli toddler is recovering from a rare operation that was performed after doctors found that some of her brain tissue had slid to her nose, placing her at risk of “catastrophic” infection.
The parents of the two-year-old from Kiryat Malachi were stunned when they checked out the prominent blue mark that had always been on the bridge of her nose and were told it was brain tissue. And they were worried to learn it meant that a nasal infection could quickly spread to the brain, causing meningitis and potentially threatening her life.
“We saw there was something on the nose, but we didn’t imagine that what was stuck there was the brain,” said her mother. “When we were told about the find, we were shocked. We feel now like we just received our daughter’s health as a gift, and we’re grateful.”
Encephaloceles are rare neural tube defects that occur when the channel that connects the brain and the spinal cord doesn’t fully close during pregnancy. They occur as protrusions on the face, nose, or on the back of the skull, and are normally noticed and removed straight after birth.
Community doctors didn’t suspect that the mark on the girl’s nose was an encephalocele. She has always been healthy and lively, so doctors paid little attention to the mark. But the mother wanted to know more, so she went to specialists.
When the girl turned two the mother took her for imaging tests at Shaare Zedek Medical Center in Jerusalem. The experts of the neurosurgery department in collaboration with the experts of the diagnostic radiology department discovered that a congenital structural change had caused part of the toddler’s brain tissue and fluid to slide into the nasal cavity.
Dr. Nevo Margalit, the Shaare Zedek doctor who performed the surgery and is releasing details now that the patient is recovering well after a three-month checkup, said that it involved sealing the skull.
“In the surgery, the skull was opened and we essentially put a plug in the hole at the bottom of the skull. In other words, we closed the floor of the skull, where there had been a hold, preventing the passage of tissue in or out,” he stated.
“The importance of this is that it blocks infection from entering the brain. The nose is not a sterile place and without this operation, there could be catastrophic infection,” he said.
Margalit added: “Had the toddler not been diagnosed, over time an infection of the nasal cavity could have developed into the brain area and caused meningitis. Fortunately, she was diagnosed, and is now recovering well from the operation and returning to a regular routine.”
