A Case of Evolving Bilateral Sphenoidal Meningoencephaloceles: Case Report and Review of the Literature

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.

Keywords: Cerebrospinal fluid rhinorrhea; Dural arteriovenous fistula; Endoscopic transpterygoid approach; Meningoencephalocele; Sphenoid sinus; Sternberg canal.