Intrasphenoidal Encephalocele with Spontaneous Cerebrospinal Fluid Rhinorrhea in Idiopathic Intracranial Hypertension: Need for Clarity in Terminology and Imaging Delineation.

Abstract

Magnetic resonance imaging plays an important role in identification of any underlying structural cause in spontaneous cerebrospinal fluid (CSF) leaks-either rhinorrhea or otorrhea. Sphenoid bone defects have been reported in those presenting as idiopathic intracranial hypertension with or without CSF rhinorrhea. Sphenoid lateral recess defect with intrasphenoidal encephalocele is one of the uncommon causes of spontaneous CSF leakage. Many classifications of basal encephaloceles have been used along with associated predisposing anatomic factors for the CSF leak. We report 2 cases of spontaneous CSF rhinorrhea in 2 middle-aged females and had intrasphenoidal encephalocele on imaging using 3-dimensional magnetic resonance cisternography and computed tomography. We discuss the various classification systems of sphenoidal encephaloceles and review the terminology and comprehensive imaging details to be included in reporting such cases for appropriate treatment planning.