Monali Chaturvedi*¹, Deepak Jha², Aldrin Anthony³ and Siddharth Maheshwari³

¹Assistant Professor Neuroradiology IHBAS, Delhi, India ²Professor Neurosurgery, AIIMS Jodhpur, India ³Assistant Professor Neurology IHBAS, Delhi, India

*Corresponding Author: Monali Chaturvedi, Department of Neuroradiology, IHBAS, Delhi, India.

Received: June 20, 2022; Published: December 07, 2022

Abstract

Spontaneous cerebrospinal fluid (CSF) leaks that occur without underlying etiology; involving the sphenoid bone are rare. They pose a diagnostic challenge and an impending risk of complications like rhinorrhea, low pressure headaches or meningitis. Causes for such spontaneous rhinorrhoea include congenital anatomic defects but involvement of sphenoid bone is rare Neuroimaging plays a pivotal role in identification of the site of leak thereby aiding surgical planning and approach for dural repair. We report two such cases of spontaneous CSF rhinorrhea presenting with watery discharge from nose and headache for a prolonged period with osteodural defects in sphenoid revealed on neuroimaging. Surgical intervention was done on one of the cases while other had a conservative management.

Keywords: Spontaneous Sphenoid; CSF Leak; MRI

References

1. Zlab MK., et al. “Cerebrospinal fluid rhinorrhea: a review of the literature”. Ear, Nose and Throat Journal 71 (1992): 314-317.
2. Wax MK., et al. “Contemporary management of cerebrospinal fluid rhinorrhea”. Otolaryngology-Head and Neck Surgery 116 (1997): 442-449.
3. Kristen M Lloyd and John M DelGaudio. “Patricia A Hudgins. Imaging of skull base CSF leaks in adults”. Radiology 248 (2008).
4. Landrenean FE., et al. “Surgical treatment of cerebrospinal fluid fistula involving lateral extension of the sphenoid sinus”. Neurosurgery 42 (1998): 1101-1105.
5. Benedict M and Schultz-Coulon HJ. “Spontaneous cerebrospinal rhinorrhea”. HNO 39 (1991): 1-7.
6. Prashant G Shetty., et al. “A Retrospective Analysis of Spontaneous Sphenoid Sinus Fistula: MR and CT Findings”. AJNR American Journal of Neuroradiology 21 (2000): 337-342.
7. Gacek RR., et al. “Adult spontaneous cerebrospinal fluid otorrhea: diagnosis and management”. American Journal of Otolaryngology 20 (1999): 770-776.
8. B Schuknecht., et al. “Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: Imaging findings and correlation with endoscopic sinus surgery in 27 patients”. AJNR American Journal of Neuroradiology 29 (2008): 542-549.
9. Shetty PG., et al. “Evaluation of high-resolution CT and MR cisternography in the diagnosis of cerebrospinal fluid fistula”. AJNR American Journal of Neuroradiology 19 (1998): 633-639.
10. Hirsch O. “Successful closure of cerebrospinal fluid rhinorrhea by endonasal surgery”. Archives of Otorhinolaryngology 56 (1952): 1-13.
11. Husain M., et al. “Neuroendoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea”. Skull Base2 (2003): 73-78.
12. Maroon JC. “Skull base surgery: past, present, and future trends”. Neurosurgical Focus 1 (2010): E1.
13. Forer B and Sethi DS. “Endoscopic repair of cerebrospinal fluid leaks in the lateral sphenoid sinus recess”. Journal of Neurosurgery 2 (2010): 444-448.

Citation

Citation: Monali Chaturvedi. “Leaking Skull Base - Imaging of Two Cases of Spontaneous Cerebrospinal Fluid (CSF) Rhinorrhea Involving Sphenoid Sinus". Acta Scientific Neurology 6.1 (2023): 23-27.

Copyright

Copyright: © 2023 Monali Chaturvedi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.