CSF rhinorrhea from a transclival meningocele: a case report

The most common site of cerebrospinal fluid (CSF) leakage is through the floor of the anterior fossa, which communicates with the ethmoid or frontal sinuses or with the nasal fossa. The sphenoid sinus is rarely implicated as a source of spontaneous CSF fistula. Transclival meningocele is an extremely rare lesion. A 36-year-old woman with a 1-year history of intermittent CSF rhinorrhea was found to have a transclival meningocele. The diagnosis of transclival meningocele was made by magnetic resonance (MR), 3-dimension-computerized tomography (CT). At operation, by a transsphenoidal approach, the transclival meningocele was packed with fasia lata graft, fat tissue, and bio-glue. This is the third case of transsphenoidal transclival meningocele producing rhinorrhea in an adult. Transclival meningocele should be taken into consideration in patients with spontaneous CSF rhinorrhea.