A case of 1 3th episode of recurrent meningitis

Here we present a case of 13th episode of recurrent meningitis probably caused by Streptococcus pneumoniae in a 23-year old male patient with a dura defect, where pneumococcal vaccine, antimicrobial prophylaxis and duroplasty by frontal craniotomy were not effective to prevent the episodes. The patient had still a small defect that was corrected by trans-sphenoidal operation after the recent episode. His clinical and radiological findings turned to be normal and the patient had no other episodes in the last 18 months. In this case, intra- and extra-cranial operation techniques in combination seemed to have a better result than a single operation.