Case Report
Focal Encephalocele Secondary to Type II Sternberg ’s Canal Defect –A Rare Phenomenon
Mohammed A* and Shastry GN
Department of General Medicine, Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India
*Corresponding author: Dr. Arfaz Mohammed, Postgraduate Resident, Department of General Medicine, Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India. E-mail Id: drarfazmd@gmail.com
Article Information: Submission: 28/08/2025; Accepted: 17/09/2025; Published: 19/09/2025
Copyright: © 2025 Mohammed A, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Sternberg’s canal (lateral craniopharyngeal canal) is an embryonic remnant from incomplete fusion of the greater wings of the sphenoid with the basisphen oid, potentially predisposing to temporal lobe encephaloceles into the sphenoid sinus. The complications seen in this condition are CSF rhinorrhea, recurrent meningitis, seizures, misdiagnosed nasal mass.
Case Presentation: A 23‑year‑old male experienced recurrent headaches for one year, initially treated as vascular headache without relief. CT brain revealed focal thinning of the left sphenoid sinus superolateral wall. MRI demonstrated a focal encephalocele abutting the infraorbital segment of the optic n erve, consistent with a Type II Sternberg’s canal defect. This patient was treated with surgical repair.
Discussion: Four types of sphenoid sinus defects are recognized based on location related to the foramen rotundum (FR) and vidian canal (VC)—Type II defects are medial to FR and are rare. Radiological imaging (CT and MRI) is essential for accurate diagnosis and surgical planning. Treatment could be conservative by using a temporary lumbar drain for small leaks or surgical management can be done by e ndoscopic endonasal repair or open transcranial repair. While most focal encephaloceles due to Sternberg ’s canal defect are isolated, they can be associated with neurocutaneous syndromes like NF1 (sphenoid wing dysplasia with basal encephalocele).
Conclusion: Type II Sternberg’s canal defects, though rare, should be considered in unexplained chronic headaches or spontaneous CSF rhinorrhea. Early imaging facilitates diagnosis and guides neurosurgical intervention.
Case Presentation: A 23‑year‑old male experienced recurrent headaches for one year, initially treated as vascular headache without relief. CT brain revealed focal thinning of the left sphenoid sinus superolateral wall. MRI demonstrated a focal encephalocele abutting the infraorbital segment of the optic n erve, consistent with a Type II Sternberg’s canal defect. This patient was treated with surgical repair.
Discussion: Four types of sphenoid sinus defects are recognized based on location related to the foramen rotundum (FR) and vidian canal (VC)—Type II defects are medial to FR and are rare. Radiological imaging (CT and MRI) is essential for accurate diagnosis and surgical planning. Treatment could be conservative by using a temporary lumbar drain for small leaks or surgical management can be done by e ndoscopic endonasal repair or open transcranial repair. While most focal encephaloceles due to Sternberg ’s canal defect are isolated, they can be associated with neurocutaneous syndromes like NF1 (sphenoid wing dysplasia with basal encephalocele).
Conclusion: Type II Sternberg’s canal defects, though rare, should be considered in unexplained chronic headaches or spontaneous CSF rhinorrhea. Early imaging facilitates diagnosis and guides neurosurgical intervention.
Keywords:Sternberg’s canal, encephalocele, sphenoid sinus, CSF leak, headache