Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Sign up to receive an email alert when a new Case of the Week is posted.
August 21, 2014
Sphenoid Encephalocele
- Herniation of intracranial contents (brain, meninges, and CSF) into the sphenoid sinus.
- Rare occurrence. Etiologies: congenital, traumatic and iatrogenic.
- Clinical Presentation:
- CSF rhinorrhea
- Occasionally: Headache and seizures
- Rarely: Symptoms from cranial nerve compression or vascular compromise
- Key Diagnostic Features:
- Presence of brain tissue within sphenoid sinus is diagnostic. If brain tissue is absent, then presence of only fluid collection can be thought to be CSF in an appropriate clinical setting.
- To diagnose using noninvasive means: HRCT demonstrates bony deshiscence. High-resolution T2WI demonstrates CSF within bony defect. If nondiagnositic/ambiguous, evaluate case using CT cisternography and nuclear scintigraphy.
- DDx:
- Arachnoid cyst
- Epidermoid cyst
- Mucocele
- Sinusitis
- Rx: Endoscopic or transcranial surgery
Current Issue
Case Collections
