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

Abstract

The evolution of sphenoid sinus meningoencephaloceles and cerebrospinal fluid (CSF) rhinorrhea is poorly understood. 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. 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.