This injury was associated with
cribiform plate fracture and CSF rhinorrhea.
Computerized tomography showed there was skull defect at floor of the anterior cranial fossa at
cribiform plate of the ethmoid on left side lateral to nasal septum.
The infection occurs when water containing the amoeba is forced up into the nasal passages, attaches to the olfactory mucosa, and migrates across the
cribiform plate into the brain via the olfactory bulbs.
Postradiation examination revealed a 6-mm mass at the posterior aspect of the
cribiform plate.
Excystation occurs quickly, and the trophozoites penetrate the nervous plexus, cross the
cribiform plate and enter the brain.
The most important pathway for absorption of CSF is via lymphatics in the olfactory tract,
cribiform plate and cervical lymphatic vessels(1).
28) The portal of entry for humans appears to be the nasal mucosa with subsequent invasion of the olfactory nerve plexus and rapid travel ( (24) hours) of the amoebae up the olfactory nerves, through the
cribiform plate and into olfactory bulb and spread to other areas of the CNS.
Those thin, spaghettilike nerves run from the nose through an opening in a skull segment called the
cribiform plate.
The diagnosis was a misplaced nasogastric tube forced through the
cribiform plate.
Our experience with this case suggests a mechanism of injury to the
cribiform plate during septoplasty that has not been described previously.
Drainage also occurs through the arachnoid villi in the sub-arachnoid space, flowing via blood and lymph into the lymphatics of the cranial nerves, the spinal nerves, inner ear and the
cribiform plate of the ethmoid bone (forms the roof of the nasal cavity) (1).
If intracranial extension is present, it classically occurs through the foramen cecum or
cribiform plate and attaches extradurally to the falx cerebri.
