Osseous dural defect or osteodural defect (ODD): Focal gap though dura & underlying skull base (SB) bone
Acquired; seen commonly with intracranial hypertension
May result from underlying congenital fissures, bone thinning, or arachnoid pits due to aberrant arachnoid granulations (AbAG)
AbAG: Arachnoid granulations that penetrate dura but fail to reach dural venous sinus
Typically at lateral edges of cribriform plate, or in floor of middle cranial fossa involving sphenoid or temporal bone from lateral wall of sella to tegmen tympani
Rarely between transverse sinus & bony labyrinth or jugular foramen region
IMAGING
Imaging Recommendations
General Features
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Hanz SZ et al: Low incidence of true Sternberg's canal defects among lateral sphenoid sinus encephaloceles. Acta Neurochir (Wien).162(10):2413-20, 2020
Hiremath SB et al: Cerebrospinal fluid rhinorrhea and otorrhea: a multimodality imaging approach. Diagn Interv Imaging. 100(1):3-15, 2019
Oakley GM et al: Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 6(1):8-16, 2016
DelGaudio JM et al: Magnetic resonance cisternogram with intrathecal gadolinium with delayed imaging for difficult to diagnose cerebrospinal fluid leaks of anterior skull base. Int Forum Allergy Rhinol. 5(4):333-8, 2015
Hasheminia D et al: A 7-year study of 1,278 patients with maxillofacial trauma and cerebrospinal fluid leak. J Maxillofac Oral Surg. 14(2):258-62, 2015
Stevens SM et al: Obesity related complications in surgery. Curr Opin Otolaryngol Head Neck Surg. 23(5):341-7, 2015
Aghaei Lasboo A et al: Emergent image-guided treatment of a large CSF leak to reverse "in-extremis" signs of intracranial hypotension. AJNR Am J Neuroradiol. 2008 Oct;29(9):1627-9. Epub 2008 Jun 26. Erratum in: AJNR Am J Neuroradiol. 31(3):E38, 2010
Algin O et al: The contribution of 3D-CISS and contrast-enhanced MR cisternography in detecting cerebrospinal fluid leak in patients with rhinorrhoea. Br J Radiol. 83(987):225-32, 2010
Selcuk H et al: Intrathecal gadolinium-enhanced MR cisternography in the evaluation of CSF leakage. AJNR Am J Neuroradiol. 31(1):71-5, 2010
Tabaee A et al: Endoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus. J Neurosurg. 112(5):1070-7, 2010
Banks CA et al: Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years. Otolaryngol Head Neck Surg. 140(6):826-33, 2009
Barañano CF et al: Sternberg's canal: fact or fiction? Am J Rhinol Allergy. 23(2):167-71, 2009
Castellan L et al: Computed tomography myelography for the assessment of iatrogenic cerebrospinal fluid (CSF) leak. J Neuroradiol. 36(2):115-7, 2009
Hoxworth JM et al: Localization of a rapid CSF leak with digital subtraction myelography. AJNR Am J Neuroradiol. 30(3):516-9, 2009
Rabadán AT et al: Pituitary tumors: our experience in the prevention of postoperative cerebrospinal fluid leaks after transsphenoidal surgery. J Neurooncol. 93(1):127-31, 2009
Sampaio MH et al: Predictability of quantification of beta-trace protein for diagnosis of cerebrospinal fluid leak: cutoff determination in nasal fluids with two control groups. Am J Rhinol Allergy. 23(6):585-90, 2009
Han ZL et al: Cerebrospinal fluid rhinorrhea following trans-sphenoidal pituitary macroadenoma surgery: experience from 592 patients. Clin Neurol Neurosurg. 110(6):570-9, 2008
La Fata V et al: CSF leaks: correlation of high-resolution CT and multiplanar reformations with intraoperative endoscopic findings. AJNR Am J Neuroradiol. 29(3):536-41, 2008
Lloyd KM et al: Imaging of skull base cerebrospinal fluid leaks in adults. Radiology. 248(3):725-36, 2008
Scholsem M et al: Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single-institution experience. Neurosurgery. 62(2):463-9; discussion 469-71, 2008
Stangherlin P et al: Benign intracranial hypertension with recurrent spontaneous cerebrospinal fluid rhinorrhoea treated by laparoscopic gastric banding. Acta Chir Belg. 108(5):616-8, 2008
Meco C et al: Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis. Laryngoscope. 114(6):991-9, 2004
Schlosser RJ et al: Elevated intracranial pressures in spontaneous cerebrospinal fluid leaks. Am J Rhinol. 17(4):191-5, 2003
Fujimaki H et al: Cerebrospinal fluid leak demonstrated by three-dimensional computed tomographic myelography in patients with spontaneous intracranial hypotension. Surg Neurol. 58(3-4):280-4; discussion 284-5, 2002
Mahapatra AK et al: Anterior encephaloceles: a study of 92 cases. Pediatr Neurosurg. 36(3):113-8, 2002
Lund VJ et al: Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhoea. J Laryngol Otol. 114(12):988-92, 2000
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KEY FACTS
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TERMINOLOGY
Definitions
Osseous dural defect or osteodural defect (ODD): Focal gap though dura & underlying skull base (SB) bone
Acquired; seen commonly with intracranial hypertension
May result from underlying congenital fissures, bone thinning, or arachnoid pits due to aberrant arachnoid granulations (AbAG)
AbAG: Arachnoid granulations that penetrate dura but fail to reach dural venous sinus
Typically at lateral edges of cribriform plate, or in floor of middle cranial fossa involving sphenoid or temporal bone from lateral wall of sella to tegmen tympani
Rarely between transverse sinus & bony labyrinth or jugular foramen region
IMAGING
Imaging Recommendations
General Features
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Hanz SZ et al: Low incidence of true Sternberg's canal defects among lateral sphenoid sinus encephaloceles. Acta Neurochir (Wien).162(10):2413-20, 2020
Hiremath SB et al: Cerebrospinal fluid rhinorrhea and otorrhea: a multimodality imaging approach. Diagn Interv Imaging. 100(1):3-15, 2019
Oakley GM et al: Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 6(1):8-16, 2016
DelGaudio JM et al: Magnetic resonance cisternogram with intrathecal gadolinium with delayed imaging for difficult to diagnose cerebrospinal fluid leaks of anterior skull base. Int Forum Allergy Rhinol. 5(4):333-8, 2015
Hasheminia D et al: A 7-year study of 1,278 patients with maxillofacial trauma and cerebrospinal fluid leak. J Maxillofac Oral Surg. 14(2):258-62, 2015
Stevens SM et al: Obesity related complications in surgery. Curr Opin Otolaryngol Head Neck Surg. 23(5):341-7, 2015
Aghaei Lasboo A et al: Emergent image-guided treatment of a large CSF leak to reverse "in-extremis" signs of intracranial hypotension. AJNR Am J Neuroradiol. 2008 Oct;29(9):1627-9. Epub 2008 Jun 26. Erratum in: AJNR Am J Neuroradiol. 31(3):E38, 2010
Algin O et al: The contribution of 3D-CISS and contrast-enhanced MR cisternography in detecting cerebrospinal fluid leak in patients with rhinorrhoea. Br J Radiol. 83(987):225-32, 2010
Selcuk H et al: Intrathecal gadolinium-enhanced MR cisternography in the evaluation of CSF leakage. AJNR Am J Neuroradiol. 31(1):71-5, 2010
Tabaee A et al: Endoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus. J Neurosurg. 112(5):1070-7, 2010
Banks CA et al: Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years. Otolaryngol Head Neck Surg. 140(6):826-33, 2009
Barañano CF et al: Sternberg's canal: fact or fiction? Am J Rhinol Allergy. 23(2):167-71, 2009
Castellan L et al: Computed tomography myelography for the assessment of iatrogenic cerebrospinal fluid (CSF) leak. J Neuroradiol. 36(2):115-7, 2009
Hoxworth JM et al: Localization of a rapid CSF leak with digital subtraction myelography. AJNR Am J Neuroradiol. 30(3):516-9, 2009
Rabadán AT et al: Pituitary tumors: our experience in the prevention of postoperative cerebrospinal fluid leaks after transsphenoidal surgery. J Neurooncol. 93(1):127-31, 2009
Sampaio MH et al: Predictability of quantification of beta-trace protein for diagnosis of cerebrospinal fluid leak: cutoff determination in nasal fluids with two control groups. Am J Rhinol Allergy. 23(6):585-90, 2009
Han ZL et al: Cerebrospinal fluid rhinorrhea following trans-sphenoidal pituitary macroadenoma surgery: experience from 592 patients. Clin Neurol Neurosurg. 110(6):570-9, 2008
La Fata V et al: CSF leaks: correlation of high-resolution CT and multiplanar reformations with intraoperative endoscopic findings. AJNR Am J Neuroradiol. 29(3):536-41, 2008
Lloyd KM et al: Imaging of skull base cerebrospinal fluid leaks in adults. Radiology. 248(3):725-36, 2008
Scholsem M et al: Surgical management of anterior cranial base fractures with cerebrospinal fluid fistulae: a single-institution experience. Neurosurgery. 62(2):463-9; discussion 469-71, 2008
Stangherlin P et al: Benign intracranial hypertension with recurrent spontaneous cerebrospinal fluid rhinorrhoea treated by laparoscopic gastric banding. Acta Chir Belg. 108(5):616-8, 2008
Meco C et al: Comprehensive algorithm for skull base dural lesion and cerebrospinal fluid fistula diagnosis. Laryngoscope. 114(6):991-9, 2004
Schlosser RJ et al: Elevated intracranial pressures in spontaneous cerebrospinal fluid leaks. Am J Rhinol. 17(4):191-5, 2003
Fujimaki H et al: Cerebrospinal fluid leak demonstrated by three-dimensional computed tomographic myelography in patients with spontaneous intracranial hypotension. Surg Neurol. 58(3-4):280-4; discussion 284-5, 2002
Mahapatra AK et al: Anterior encephaloceles: a study of 92 cases. Pediatr Neurosurg. 36(3):113-8, 2002
Lund VJ et al: Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhoea. J Laryngol Otol. 114(12):988-92, 2000
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