case_images: PMC10927183_01
case_images: Magnetic resonance imaging of brain and sinuses showing cerebrospinal fluid leak into the left posterior ethmoidal air cells (arrow).
case_images: SNI-15-61-g001.jpg
case_images: PMC10927183_01_SNI-15-61-g001.jpg
case_images: F1
case_images: She was admitted to the hospital and investigated with an MRI brain demonstrating fluid in the left posterior ethmoid air cells as well as optic nerve sheath enlargement bilaterally, consistent with intracranial hypertension and CSF leak [Figure 1].
case_images: Obstructed superior vena cava and extensive collaterals (arrow).
case_images: SNI-15-61-g002.jpg
case_images: PMC10927183_01_SNI-15-61-g002.jpg
case_images: F2
case_images: A venogram and manometry were also performed, which confirmed the presence of SVC obstruction with extensive venous collaterals [Figure 2] as well as a separate near-complete obstruction of the right IJV at the level of C4 downward.
case_images: Patent superior vena cava post stenting and balloon dilatation.
case_images: SNI-15-61-g003.jpg
case_images: PMC10927183_01_SNI-15-61-g003.jpg
case_images: F3
case_images: Successful stenting of the patient's SVC and balloon dilatation of her right IJV [Figure 3] resulted in an improvement in her headaches and blurred vision.
case_images: Endoscopic endonasal view of herniating meningocele in the left posterior ethmoid space.
case_images: SNI-15-61-g004.jpg
case_images: PMC10927183_01_SNI-15-61-g004.jpg
case_images: F4
case_images: The source of the leak was identified as a herniating meningocele in the left posterior ethmoid [Figure 4].