Computerized tomography angiography is equal to DS angiography in the detection and superior to DS angiography and MR angiography in the characterization of brain aneurysms. Information contained in volume-rendered CT angiography images had a significant impact on case management.

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There have been no previous reports of a spontaneous cerebrospinal fluid fistula through the clivus. We present two such cases, describe their management, and propose a physiopathological explanation. The pulsating effect of the basilar artery in Patient 1 and brisk increases in intracranial pressure through repeated Valsalva maneuvers, acting on a congenitally thin bone in Patient 2, seem to be the plausible causes for the clival leakage.

No abstract