title: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India.
authors.forename: Varun
authors.initials: V
authors.lastname: Aggarwal
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India. Electronic address: drprakashnair@gmail.com.
authors.forename: Prakash
authors.initials: P
authors.lastname: Nair
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Shivhare
authors.affiliation: Department of IS and IR, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India.
authors.forename: E R
authors.initials: ER
authors.lastname: Jayadevan
authors.affiliation: Department of ENT, Sree Uthradom Thirunal Hospital (SUT), Trivandrum, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Felix
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India.
authors.forename: Mathew
authors.initials: M
authors.lastname: Abraham
authors.affiliation: Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), Trivandrum, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Nair
mesh_terms: D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D065634:Cerebrospinal Fluid Leak / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D018450:Disease Progression; D004677:Encephalocele / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008588:Meningocele / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013101:Sphenoid Sinus
keywords: Cerebrospinal fluid rhinorrhea; Dural arteriovenous fistula; Endoscopic transpterygoid approach; Meningoencephalocele; Sphenoid sinus; Sternberg canal