Detection of an occult transclival cerebrospinal fluid fistula by CT and MRI.
We describe an unusual occult transclival cerebrospinal fluid (CSF) fistula to the sphenoid sinus demonstrated by MRI. CT was performed because of a posterior cerebral infarct caused by cardiac arrhythmia. Axial sections showed fluid in the sphenoid sinus. High-resolution scans revealed a bony defect 3 mm in diameter of the posterior wall of the sphenoid sinus, and MRI showed a transclival CSF fistula. This occult lesion was confirmed by surgery and duraplasty was successfully performed via an endonasal approach.
Schick
B
B
Department of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Communication Disorders, Academic Teaching Hospital, Marburg University, Fulda, Germany.
Brors
D
D
Goedecke
A
A
Prescher
A
A
Draf
W
W
D016080:Arachnoid Cysts / Q000150:complications; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005402:Fistula / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed