Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele?

A diagnosis dilemma

Noor Azrin Md Anuar, Narizan Ariffin, Teoh Jian Woei, Balwant Singh Gendeh

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)150-153
Number of pages4
JournalEastern Journal of Medicine
Volume21
Issue number3
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Sphenoid Sinus
Mucocele
Cerebrospinal Fluid
Delayed Puberty
Nasal Polyps
Punctures
Headache
Spinal Cord
Tomography
Magnetic Resonance Imaging
Brain

Keywords

  • CSF leak
  • Mucocele
  • Pseudomeningocele
  • Transphenoidal surgery

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele? A diagnosis dilemma. / Md Anuar, Noor Azrin; Ariffin, Narizan; Woei, Teoh Jian; Gendeh, Balwant Singh.

In: Eastern Journal of Medicine, Vol. 21, No. 3, 2016, p. 150-153.

Research output: Contribution to journalArticle

Md Anuar, Noor Azrin ; Ariffin, Narizan ; Woei, Teoh Jian ; Gendeh, Balwant Singh. / Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele? A diagnosis dilemma. In: Eastern Journal of Medicine. 2016 ; Vol. 21, No. 3. pp. 150-153.
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