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Insights into Imaging
Fig. 16 | Insights into Imaging

Fig. 16

From: What's that smell? A pictorial review of the olfactory pathways and imaging assessment of the myriad pathologies that can affect them

Fig. 16

Acquired non-traumatic CSF fistula secondary to idiopathic intracranial hypertension (IIH). 43-year-old female patient diagnosed with IIH at the age of 16 but lost to follow up, presenting with nasal congestion, CSF rhinorrhoea, and blurred vision. Sequential coronal T2W sequences (a, b) demonstrate a large left meningoencephalocoele herniating through the left olfactory recess (arrow, a), extending down into the nasal cavity and obstructing the left osteomeatal complex (arrow, b). Heavily T2 weighted CISS sequence (c) demonstrates the normal olfactory tract surrounded by CSF on the right (long arrow), and the abnormal herniating brain tissue on the left (short arrow). An “empty sella” with tortuous optic nerves and dilated subarachnoid spaces around the optic nerves are consistent with IIH, which is a well-described cause of acquired CSF fistulas

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