Tension pneumocephalus and rhinorrhea related to chronic sinusitis

A 42-year-old woman presented with a sudden-onset severe headache associated with vomiting and a persistent aqueous rhinorrhea. She had an allergic chronic sinusitis. There was no history of head trauma. Neurologic exam disclosed papilledema. The computed tomography (CT) scan showed opacification of the left sphenoid sinus and pneumocephalus extending from frontal region until convexity, compressing the supratentorial ventricular system (Fig 1). The cerebrospinal fluid (CSF) fistula was found in the left pterygoid process (Fig 2). Air probably came through the [...]