A 66-year-old woman was admitted in the Neurology Department because of 2 month repeatedly headache, aggravating within 1 week. The localization of headache was mainly on left side of forehead, tempus, and cheek. It showed as intermittent pain, worse in the morning and tended to aggravate when she lowered her head. 1 week before she was admitted in hospital, headache was persistent accompanied by upper teeth pain on left side. She had hypertension (blood pressure 177/88 mmHg) and occasional nasal bleeding. There was no positive symptoms in nervous system. Brain CT imagine showed scattered demyelination in white matter of both frontoparietal lobes and inflammation in the left maxillary and sphenoid sinus. Further enhanced Brain MRI also demonstrated scattered demyelination in white matter of both frontoparietal lobes, inflammation of paranasal sinuses, and mucoceles in the left sphenoid sinus. Then, this patient was referred to the Otolaryngology Department. Further paranasal sinus CT demonstrated abnormal intensity of soft tissue in left sphenoid sinus, protrusion to the sinus cavity with nodular calcification. Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed left sphenoid sinus as SSFB. Follow-up of 10 months demonstrated no further recurrence of her headache.
A 59-year-old woman visited out-patient clinic of neurology because of 3 years intermittent sharp pain on left orbital. She was diagnosed as trigeminal neuralgia in the community hospital. Then, she was treated with Carbamazepine, Mecobalamin and acupuncture, but without significant relief. Our examination found tenderness at the exit of the left supraorbital nerve. MRI imagine demonstrated that partial empty sella and left sphenoid sinus. This patient was referred to the Otolaryngology Department. Paranasal sinus CT demonstrated inflammation of left sphenoid sinus. Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed left sphenoid sinus as SSFB. Follow-up of 2 month demonstrated no further recurrence of her headache.\nAll of the major clinical information in patients with SSFB was summarized in the Table .