Spontaneous CSF rhinorrhea - MRI CISS images - cribriform plate defect

25 year old lady with four months history of profuse watery discharge from right nostril. Anosmia in right nostril. No raised ICP features.

The defect in the cribriform plate was quite small. The olfactory bulb and tract were lying free without attachment to the plate on the affected right side. The olfactory bulb and tract were preserved on the left side. [could have almost got sucked away at one point].
Bicoronal sinusoidal stealth incision - bifrontal craniotomy. [cosmetic reasons]
Abdominal fat graft and vascularised pericranial graft onlay on both sides. [just to be totally sure...]
Post op: no leak. olfactory function preserved.