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A 29-year-old soldier had a two-day history of headache and fever. He reported having had an intermittent, clear nasal discharge from the left nostril since his involvement in a minor motor vehicle accident two years earlier. Lumbar puncture revealed a white-cell count of 4100 per cubic millimeter, with 98 percent neutrophils — a finding indicative of bacterial meningitis, even though the microbiologic culture grew no organisms. Coronal computed tomography showed absence of the left ethmoidal plate and a focal brain herniation (Panel A, arrow). Incidental maxillary-sinus retention cysts were seen bilaterally. Endoscopic rhinoscopy revealed a small, pulsating mass consistent with . . . [Full Text of this Article] |
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