case_images: PMC2929619_01
case_images: Postgadolinium coronal T1 weighted image showing an enhancing, soft tissue mass involving the right side of the sphenoid sinus and extending into the right cavernous sinus and into the suprasellar cistern.
case_images: CRM2010-312081.001.jpg
case_images: PMC2929619_01_CRM2010-312081.001.jpg
case_images: fig1
case_images: Magnetic resonance imaging demonstrated an extensive skull base lesion involving the sphenoid and ethmoid sinuses, pituitary fossa, and suprasellar region (Figure 1).
case_images: Coronal CT scan showing soft tissue mass in the sphenoid sinus with destruction of the roof of the sphenoid sinus.
case_images: CRM2010-312081.002.jpg
case_images: PMC2929619_01_CRM2010-312081.002.jpg
case_images: fig2
case_images: Computed tomography of the sinuses revealed bony destruction (Figure 2).
case_images: CT cisternogram showing a right-sided CSF leak through the roof of the sphenoid sinus.
case_images: CRM2010-312081.003.jpg
case_images: PMC2929619_01_CRM2010-312081.003.jpg
case_images: fig3
case_images: A CT cisternogram was undertaken to further characterise the site of CSF leakage (Figure 3).
case_images: Noncontrast CT head scan showing extensive intraventricular and subarachnoid air.
case_images: CRM2010-312081.004.jpg
case_images: PMC2929619_01_CRM2010-312081.004.jpg
case_images: fig4
case_images: Both attempts were unsuccessful and lumbar CSF drainage resulted in profound pneumocephalus (Figure 4).
case_images: Sagittal reconstruction cisternogram image showing contrast in the sphenoid sinus consistent with persistent CSF leak.
case_images: CRM2010-312081.005.jpg
case_images: PMC2929619_01_CRM2010-312081.005.jpg
case_images: fig5
case_images: Once sufficient neurological recovery had occurred, a second CT cisternogram (Figure 5) was undertaken prior to a further endoscopic endonasal repair using fat graft and fascia lata.