Nontraumatic Skull Base Defects With Spontaneous CSF Rhinorrhea and Arachnoid Herniation: Imaging Findings and Correlation With Endoscopic Sinus Surgery in 27 Patients

Abstract

BACKGROUND AND PURPOSE:Defects at the skull base leading to spontaneous CSF rhinorrhea are rare lesions. The purpose of our study was to correlate CT and MR findings regarding the location and content of CSF leaks in 27 patients with endoscopic sinus surgery observations.

Prevalence and Appearance of the Posterior Wall Defects of the Temporal Bone Caused by Presumed Arachnoid Granulations and Their Clinical Significance: CT Findings

“…Aside from AGs, various factors have been postulated as the pathogenesis of creation of osteodural defects in various locations related to spontaneous CSF leaks, such as elevated intracranial pressure, empty sella, and congenital cause. 22 This is why we selected the term "presumed AGs" instead of "AGs." To validate our results, further comparative study by using high-resolution CT and MR imaging of the temporal bone is highly warranted.…”

Fístula de líquido cefalorraquídeo del receso lateral de seno esfenoidal. ¿Es el canal de Sternberg un defecto real?

“…La causa más probable de origen de estas lesiones es la combinación de una neumatización extensa del receso lateral esfenoidal y el desarrollo de defectos aracnoideales en el hueso que remodelan este último por efecto de hipertensión endocraneana [20][21] . Esta teoría fue recientemente apoyada por Schuknecht y col, los que encontraron estos defectos aracnoidales en siete de ocho fístulas de receso lateral con rinorrea espontánea 22 .…”

‘Do not touch’ lesions of the skull base

“…4 LSMs are often asymptomatic and incidentally discovered on imaging studies; however, patients may present with spontaneous CSF rhinorrhea and/or prior history of meningitis and in these cases may require surgical repair. 5 …”