PMC6169345_01
Nonenhanced computerized tomography scans showing in the (a) axial and (b) coronal planes, extra-axial, subarachnoid, and intraventricular air (arrows in b shows depression of the ventricular wall causing distortion of the bilateral caudate nuclei). (c) Coronal computerized tomography scan with arrow depicting bony defect caused by iatrogenic transgression of the fovea ethmoidalis
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F1
Computed tomography on presentation showed prominent pneumocephalus with intraventricular air causing enlargement of the anterior horns of both lateral ventricles with lateral displacement of the basal ganglia nuclei bilaterally [Figure 1a] and a bony defect at the lateral lamella and fovea ethmoidalis with formation of an encephalocele [Figure 1b and c].
Endoscopic endonasal view via the right nare with arrows showing bony defect edge with dural violation and encephalocephele. Insert shows perspective (The Rhoton collection)
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F2
Emergent endoscopy confirmed an anterior skull base defect of approximately 1.5 cm with associated encephalocele [Figure 2].