A Case Of Fluid In The Right Occipital Condyle Secondary To Persistent Increase In Intracerebral Pressure

In a case of Cerebrospinal Fluid (CSF) leak from the ear, radiological investigations are mainly performed to examine and evaluate the mastoid bones. Occipital condyles are often overlooked. The usual causes for CSF to leak into the ear are related to factors that cause an increase in intracerebral pressure. Similar factors may also be responsible for the formation of a pneumatocele and subsequent pneumatisation of the mastoid and occipital bones. Pneumatization in the skull is normally confined to the mastoid process. Pneumatization in bones other than the temporal bone such as the occipital bone is exceptionally rare and has very few cases reported so far. It has been postulated that occipital pneumatization is a consequence of communication between the temporal and occipital bones. Persistently increased intraluminal pressure has been proposed as a mechanism of pneumocele formation which later progresses to pneumatisation of occipital bones. Fluid in the occipital bones following increased intracerebral pressure has not yet been reported. Isolated cases of pneumatocysts within the occipital condyle however have been documented. If the cause for such pneumatisation or fluid accumulation is left untreated then complications such as spontaneous intracranial epidural accumulation of air, fracture of C1 and the occipital bone, spontaneous subcutaneous emphysema and pneumatocele formation can occur leading to severe morbidity and mortality. We present a case of CSF Rhinorrhea and Otorrhea in a 41 year old male secondary to a space occupying lesion in the right lateral ventricle of the brain with fluid in the right occipital condyle with a review of relevant literature.