Imaging of skull-base cephalocoeles and cerebrospinal fluid leaks

Skull-base cephalocoeles and cerebrospinal fluid (CSF) leaks may be congenital, spontaneous, or secondary. A classification of congenital lesions is formulated and the imaging features are illustrated. The concept of spontaneous skull-base CSF leaks and the significance of aberrant arachnoid granulations in imaging these patients are explored. The majority of secondary lesions relate to trauma; however, other potential causes of secondary skull-base cephalocoeles and CSF leaks are discussed. Imaging evaluation in these clinical scenarios may be complex and the role of each imaging method is reviewed. (C) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.