Varun Aggarwal1, Prakash Nair2, Pankaj Shivhare1, E R Jayadevan3, Vinod Felix4, Mathew Abraham1, Suresh Nair1. 1. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India. 2. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India. Electronic address: drprakashnair@gmail.com. 3. Department of IS and IR, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India. 4. Department of ENT, Sree Uthradom Thirunal Hospital (SUT), Trivandrum, India.
Abstract
BACKGROUND: The evolution of sphenoid sinus meningoencephaloceles and cerebrospinal fluid (CSF) rhinorrhea is poorly understood. CASE DESCRIPTION: We present a case demonstrating the gradual evolution of encephaloceles from both the lateral walls of a previously normal sphenoid sinus in a patient with dural arteriovenous fistula; the CSF leak that developed after staged embolization of the dural arteriovenous fistula was managed by an endoscopic endonasal transpterygoid approach. CONCLUSIONS: We suggest that over a period of time, chronic elevation of intracranial pressure can result in gradual erosion of the lateral wall of the sphenoid with development of meningoencephaloceles and CSF leaks.
BACKGROUND: The evolution of sphenoid sinus meningoencephaloceles and cerebrospinal fluid (CSF) rhinorrhea is poorly understood. CASE DESCRIPTION: We present a case demonstrating the gradual evolution of encephaloceles from both the lateral walls of a previously normal sphenoid sinus in a patient with dural arteriovenous fistula; the CSF leak that developed after staged embolization of the dural arteriovenous fistula was managed by an endoscopic endonasal transpterygoid approach. CONCLUSIONS: We suggest that over a period of time, chronic elevation of intracranial pressure can result in gradual erosion of the lateral wall of the sphenoid with development of meningoencephaloceles and CSF leaks.