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.
A 61-year-old woman visited out-patient clinic of neurology because of 1 year intermittent distending pain on the right occipital, aggravating within 10 days. She received treatment from the community hospital but without relief. There was no positive symptoms in nervous system. CT scan did not show any abnormal alteration in brain parenchyma. It indicated right fungal sphenoid sinusitis. Then, this patient was referred to the Otolaryngology Department. Paranasal sinus CT abnormal intensity of soft tissue in right sphenoid sinus with calcification, bone damage on sinus wall, fungal sphenoid sinusitis. Patient undertook transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed right sphenoid sinus as SSFB. Follow-up of 5 months demonstrated no further recurrence of her headache.