A lumbar puncture with cytologic examination may be helpful. If a primary neoplasm of the nasopharynx is suspected, a biopsy may be needed. In the case of pituitary tumors with lateral extension, tumor resection may be necessary. Rarely, a biopsy of the cavernous sinus tumor is needed for diagnosis. Perform angiography if balloon occlusion of the aneurysm is planned.
Cerebral angiography is the only way to arrive at the correct diagnosis.
Perform angiography to treat the fistula. An aseptic thrombosis may be associated with conditions such as hypercoagulable states and lymphoproliferative disorders. A hematologic workup is indicated in these patients. Miscellaneous inflammatory syndromes Investigate additional systemic inflammatory and granulomatous processes after other common causes have been excluded. These disorders can be screened by studies such as laboratory tests and chest x-ray.