An unusual cause of headache and nasal discharge in a 40-year-old female

Abstract

A 40-year-old woman presented with severe headache precipitated by sneezing. Examination revealed a right watery nasal discharge that was increased with the Valsalva maneuver. She had no history of surgery or trauma. A CT scan of the paranasal sinuses revealed a bony defect involving the lateral wall of the right sphenoid sinus extending into the pterygoid recess of the sphenoid sinus (Fig. 1A). Normal aeration was seen in the left sphenoid sinus compared to soft tissue density on the right (Fig. 1B).