Imaging features are suggestive of ethmoidal meningocele without brain tissue herniation complicated with CSF leakage (CSF rhinorrhea).

The patient was planned for a semi-emergency operation of skull base repair. Unfortunately, patient developed pulmonary embolism before the operation. She is now on anticoagulant as treatment for pulmonary embolism and under ENT clinic follow up.

Ethmoidal meningocele represents extracranial herniation of meninges and CSF through a cranial defect in the anterior cranial fossa.

Its complications include meningitis and CSF leakage.

It could be an incidental finding, which mimics ethmoidal mucosal thickening or ethmoidal mucocele. Findings of cranial defect can confirm the diagnosis.

CT and MRI are helpful to diagnose meningocele ¹.