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Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele?: A diagnosis dilemma [Eastern J Med]
Eastern J Med. 2016; 21(3): 150-153 | DOI: 10.5505/ejm.2016.78973  

Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele?: A diagnosis dilemma

Noor Azrin Md Anuar1, Narizan Ariffin1, Teoh Jian Woei1, Balwant Singh Gendeh2
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A pseudomeningocele is an abnormal collection of cerebrospinal fluid (CSF) that communicates with the CSF space around the brain or spinal cord. We describe a rare case of spontaneous non-traumatic pseudomeningocele in a 28 year-old gentleman who presented with delayed puberty associated with headache. Computed tomography revealed an expansile mass over bilateral sphenoid sinuses. Magnetic resonance imaging supported the diagnosis of sphenoid mucocele. A transnasal transphenoidal endoscopic sphenoidotomy was performed. Intraoperatively, despite an anatomical puncture through the sphenoid ostium, alarmingly, the opening leaked out CSF. A dehiscent was identified with a dural opening. This was repaired with multilayer technique. Clinical improvement was observed post-operatively. The case reported here is unusual as they presented on imaging as a fluid collection in sphenoid sinus simulating a mucocoele, but were filled with CSF and represent pseudomeningocele. Surgeons should be alert to the presence of pseudomeningocele as they can mimic a mucocele or nasal polyp.

Keywords: CSF leak, mucocele, pseudomeningocele, transphenoidal surgery


Noor Azrin Md Anuar, Narizan Ariffin, Teoh Jian Woei, Balwant Singh Gendeh. Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele?: A diagnosis dilemma. Eastern J Med. 2016; 21(3): 150-153


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