Hello doctor, I have been struggling for approximately two years with symptoms such as pulsatile tinnitus, dizziness, vertigo, orthostatic headaches and general fatigue. I had an MRI that showed empty Sella with some herniation of CSF into the pituitary gland area. I have a set of images from a CT angiogram as at the time I was under investigation for some sort of arteriovenous malformation (suspected) but was given the all-clear. The reason for the second opinion is I believe the cause of my symptoms has been missed as the coronal and sagittal images from my recent scan I do not think have been looked at. In my opinion, there seems to be a defect in the left cribriform plate adjacent to an opacified ethmoid air cell. I think this may be causing a CSF flow problem and hence all my symptoms. I have attached a snapshot of the area but please could you look at the coronal and sagittal images?
Hello. The MRI findings are suggestive of benign intracranial hypertension and these also correlate well with your symptoms. In the scan provided, no obvious defect is seen in either of the cribriform plates. The CT angiogram is within normal limits. But still, if you have rhinorrhea (a runny nose) then the possibility of CSF leak needs to be ruled out accurately using CT cisternography scan. Please upload the coronal images so that I can evaluate the complete scan. This is only a second opinion platform. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings. For more information consult a radiologist online -->