Rare intracranial manifestations of frontal osteomas

Osteomas of the paranasal sinuses are usually asymptomatic. When enlarged, they could give rise to intracranial manifestations and serious complications. Osteomas most commonly affect the fronto-ethmoid sinuses. They rarely show intra-orbital extension or cause intracranial complications such as CSF rhinorrhea, pneumocephalus and intracranial infection. We report two unusual cases of frontal osteomas complicated by rare manifestations such as intracranial mucocele, CSF leak, pneumocephalus and bacterial meningitis. We demonstrate the importance of these intracranial manifestations when these lesions are accompanied by neurological symptoms and signs with special emphasis on the importance of early treatment.