case_images: PMC10390265_01
case_images: CT sinus without contrast axial cut showing the air-fluid level in the sphenoid sinus and defect in the clivus (see arrow).
case_images: CRIOT2023-3205191.001.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.001.jpg
case_images: fig1
case_images: Her CT skull base without contrast (Figures 1 and 2) and MRI skull base with IV contrast (Figures 3 and 4) showed clival defect with pseudomeningocele and no signs of increased ICP.
case_images: CT sinus without contrast sagittal cut showing the air-fluid level in the sphenoid sinus and defect in the clivus (see arrow).
case_images: CRIOT2023-3205191.002.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.002.jpg
case_images: fig2
case_images: Her CT skull base without contrast (Figures 1 and 2) and MRI skull base with IV contrast (Figures 3 and 4) showed clival defect with pseudomeningocele and no signs of increased ICP.
case_images: MRI skull base with IV contrast axial cut showing fluid accumulation in sphenoid communicating with clival defect (see arrow).
case_images: CRIOT2023-3205191.003.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.003.jpg
case_images: fig3
case_images: Her CT skull base without contrast (Figures 1 and 2) and MRI skull base with IV contrast (Figures 3 and 4) showed clival defect with pseudomeningocele and no signs of increased ICP.
case_images: MRI skull base with IV contrast sagittal cut showing fluid accumulation in sphenoid communicating with clival defect (see arrow).
case_images: CRIOT2023-3205191.004.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.004.jpg
case_images: fig4
case_images: Her CT skull base without contrast (Figures 1 and 2) and MRI skull base with IV contrast (Figures 3 and 4) showed clival defect with pseudomeningocele and no signs of increased ICP.
case_images: (a)-(c): (a) Fluorescein dye coming from the defect site. (b) Bovine pericardium graft placed over the defect followed by fibrin sealant. (c) Pedicled septal flap placed over the defect.
case_images: CRIOT2023-3205191.005.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.005.jpg
case_images: fig5
case_images: Intraoperatively, fluorescein confirmed the leak coming from the clivus and there was no other leak identified (Figure 5(a)). An onlay bovine pericardium graft was placed followed by a fibrin sealant (Figure 5(b)). Then, a pedicled septal flap was placed over it (Figure 5(c)).
case_images: 10 months postoperative endoscopic picture showing healed skull base.
case_images: CRIOT2023-3205191.006.jpg
case_images: PMC10390265_01_CRIOT2023-3205191.006.jpg
case_images: fig6
case_images: On her 9-month follow-up visit, the patient was doing well with no evidence of recurrence (Figure 6).