A 48-year-old woman visited out-patient clinic of neurology after 2 weeks of headache. The localization of headache was mainly on right side of head. It showed as intermittent dull pain, especially at night. Headache was relieved after taking pain reliever. However, headache occurred again when she stopped taking medicine. The patient visited out-patient clinic of neurology again. There was no abnormal change in brain parenchyma after taking brain CT scan. However, occupying lesion was found in the right sphenoid sinus. This patient was immediately hospitalized in the Otolaryngology Department. Further paranasal sinus CT demonstrated abnormal density of the right sphenoid sinus with calcification and lesion on the sinus wall (Figure ). Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed right sphenoid sinus as SSFB (Figure ). No further recurrence of her headache was found after 14 months follow-up.
A 46-year-old woman visited out-patient clinic of neurology after 1 month of headache. The localization of headache was mainly on left forehead. It showed as persistent dull pain, especially at night. Patient had occasional dizziness. After taking medicine prescribed from community hospital, headache relieved, but could not cure. Then, patient visited our out-patient clinic of neurology. There was no positive symptoms in nervous system. Brain MRI exam demonstrated that few demyelination in white matter of both frontal lobe and inflammation in sphenoid sinus. This patient was then hospitalized in the Otolaryngology Department. Further paranasal sinus CT demonstrated inflammation in left sphenoid sinus. Patient undertook transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed left sphenoid sinus as SSFB. No further recurrence of her headache happened after 11 months follow-up.