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Con- genital dehiscences in the lateral sphenoid roof that occur as a result of persistence of the lateral craniopharyngeal canal (Sternberg canal) have also been implicated in the pathogen- esis of sphenoid CSF leaks and meningoencephaloceles.38,39 This relationship between the Sternberg canal and sphenoid meningoencephaloceles has been discounted by other authors.40 In all instances of thinning of the bony skull base, the pressure from the overlying intracranial contents coupled with constant dural pulsations may further erode the weakened area and result in development of CSF rhinorrhea.
A meningocele or meningoencephalocele may occur in association with CSF rhinorrhea, although each of these may occur independently.
If the defect is large enough, and sufficient time has elapsed, a meningoencephalocele may even- tually develop.
Often CSF rhinorrhea is the presenting symptom of a meningocele or meningoencephalocele, but CSF rhinor- rhea is not a concomitant finding in many patients with con- firmed meningoceles (or meningoencephaloceles).
In this strat- egy, CT and MR are complementary; that is, CT provides detail about the bony anatomy, including bony skull base dehiscences (Fig. 52-6), and MR provides detail about soft tissues, including coincident meningoencephaloceles and incidental intracranial masses (Fig. 52-7).
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