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Judith Wagner, MD; Christoph Schankin, MD; Thomas Klopstock, MD; Klaus Seelos, MD; Andreas Leunig, MD; Andreas Straube, MD

Arch Neurol. 2009;66(8):1038.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 48-year-old man presented with a 1.5-year history of rhinorrhea, which increased on tilting the head forward or backward. There was no history of trauma, meningitis, or other relevant disease. No further neurological symptoms were reported and the physical examination results were unremarkable. The nasal secretion was positive for cerebrospinal fluid (CSF)–specific β₂-transferrin. A cranial computed tomographic scan revealed an extensively pneumatized sphenoid sinus with a bony defect of the right sinus (Figure 1A). A magnetic resonance image revealed a fluid-filled cyst protruding into the right sphenoid sinus (Figure 1B). Hence, the patient was diagnosed with a spontaneous sphenoid sinus fistula. Closure of the fistula was attempted via an endonasal endoscopic approach. Intraoperatively, a submucosal collection of CSF was exposed at the back of the sinus after . . . [Full Text of this Article]

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