case_images: PMC11151402_01
case_images: (a and c) Axial and coronal CT sections demonstrate a defect in the right lateral wall of the sphenoid sinus (red arrows). (b and d) Axial and coronal T2-weighted sequences reveal the herniated portion of right medial temporal lobe (red arrows).
case_images: SAJR-28-2829-g005.jpg
case_images: PMC11151402_01_SAJR-28-2829-g005.jpg
case_images: F0005
case_images: Non-contrast CT of the paranasal sinuses (PNS) revealed a defect in the right lateral wall of the SS with pneumatisation of the lateral recesses (Figure 5a and c). SS (Figure 5b and d). Multiple tiny arachnoid pits were seen in the greater wing of sphenoid on the right side (Figure 7). Signs of increased intracranial pressure, namely prominence of the subarachnoid spaces around both optic nerves, enlarged Meckel's caves and prominent arachnoid pits were present (Figure 8).
case_images: CT cisternography coronal and sagittal reformatted images. (a and d) Demonstrate a defect in the right lateral wall of the sphenoid (yellow arrow). (b and c) Opacification of sphenoid sinus, (*) The herniated temporal lobe.
case_images: SAJR-28-2829-g006.jpg
case_images: PMC11151402_01_SAJR-28-2829-g006.jpg
case_images: F0006
case_images: Imaging with CT cisternography revealed opacification of the right half of the SS with hyperdense fluid from the subarachnoid space of the middle cranial fossa surrounding the herniated brain tissue (Figure 6).
case_images: (a, b, c, d) Shows multiple arachnoid pits in the right greater wing of sphenoid. (e) Defect medial to the VR line in the location of Sternberg's canal suggestive of a Type 1 SLSC with a Type I leak. (yellow arrows indicate the arachnoid pits and osseous sphenoid defects).
case_images: SAJR-28-2829-g007.jpg
case_images: PMC11151402_01_SAJR-28-2829-g007.jpg
case_images: F0007
case_images: SS (Figure 5b and d). Multiple tiny arachnoid pits were seen in the greater wing of sphenoid on the right side (Figure 7). Signs of increased intracranial pressure, namely prominence of the subarachnoid spaces around both optic nerves, enlarged Meckel's caves and prominent arachnoid pits were present (Figure 8).
case_images: Signs of intracranial hypertension. (a) Prominent subarachnoid spaces around both optic nerves. (b) Enlarged Meckel's caves bilaterally. (c, d, e, f) Multiple arachnoid pits with tiny meningocoeles (yellow arrows).
case_images: SAJR-28-2829-g008.jpg
case_images: PMC11151402_01_SAJR-28-2829-g008.jpg
case_images: F0008
case_images: SS (Figure 5b and d). Multiple tiny arachnoid pits were seen in the greater wing of sphenoid on the right side (Figure 7). Signs of increased intracranial pressure, namely prominence of the subarachnoid spaces around both optic nerves, enlarged Meckel's caves and prominent arachnoid pits were present (Figure 8).
case_images: Intraoperative photograph showing the osseous defect (blue arrow) in the sphenoid sinus and temporal dural defect (yellow arrow).
case_images: SAJR-28-2829-g009.jpg
case_images: PMC11151402_01_SAJR-28-2829-g009.jpg
case_images: F0009
case_images: A right pterional craniotomy was performed, followed by extradural dissection to identify the bony defect and the temporal lobe encephalocoele (Figure 9).
case_images: PMC11151402_02
case_images: (a) Coronal reformatted CT reveals a bony defect in the roof of the left lateral wall, lateral to the foramen rotundum - Type 1 spontaneous lateral sphenoid cephalocoele (SLSC) with a type III leak. (b and c) CT cisternography sagittal and axial reformatted images show contrast leakage from the subarachnoid space to the left half of the sphenoid sinus. (d) Coronal T2-weighted sequence shows herniated brain tissue within the sphenoid sinus.
case_images: SAJR-28-2829-g010.jpg
case_images: PMC11151402_02_SAJR-28-2829-g010.jpg
case_images: F0010
case_images: CT of the PNS revealed a defect in the roof of left lateral wall of the SS with thinning of the greater wing and full lateral sphenoid pneumatisation (Figure 10A). CT cisternography revealed opacification of the left half of the SS (Figure 10b and c) and MRI confirmed herniation of the medial temporal lobe through the bony defect (Figure 10d) which was classified as a Type 1 SLSC with a type III CSF leak (lateral to VR line).
case_images: PMC11151402_03
case_images: (a) Axial CT reveals intraparenchymal haemorrhage in the left gangliocapsular region with intraventricular extension. (b and c) Axial and Coronal CT demonstrates the defect in the right lateral wall of sphenoid sinus. (d) Herniated brain tissue within the sphenoid.
case_images: SAJR-28-2829-g011.jpg
case_images: PMC11151402_03_SAJR-28-2829-g011.jpg
case_images: F0011
case_images: Incidental note of a 7mm bone defect in the right lateral wall and floor of the SS with herniation of brain tissue (Figure 11 and Figure 12) was made.
case_images: (a) Defect medial to the vidian canal (VR line) without extension of pneumatisation into the pterygoid or greater wing - type I leak. (b and c) Dehiscent floor of the sphenoid sinus. (d) Surface shaded display reveals the defect in the floor of sphenoid sinus communicating with the nasopharynx.
case_images: SAJR-28-2829-g012.jpg
case_images: PMC11151402_03_SAJR-28-2829-g012.jpg
case_images: F0012
case_images: Incidental note of a 7mm bone defect in the right lateral wall and floor of the SS with herniation of brain tissue (Figure 11 and Figure 12) was made.