Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Moore, K. R. Articles by Dillon, W. P. Search for Related Content PubMed PubMed Citation Articles by Moore, K. R. Articles by Dillon, W. P.

American Journal of Neuroradiology 22:1867-1871 (November 2001)
© 2001 American Society of Neuroradiology

HEAD AND NECK

Petrous Apex Cephaloceles

Kevin R. Moore^a, Nancy J. Fischbein^a, H. Ric Harnsberger^a, Clough Shelton^a, Christine M. Glastonbury^a, David K. White^a and William P. Dillon^a

^a From the Departments of Radiology (K.R.M., H.R.H., C.M.G., D.K.W.) and Otolaryngology (C.S.), University of Utah School of Medicine, Salt Lake City; and the Department of Radiology, University of California at San Francisco (N.J.F., W.P.D.).

BACKGROUND AND PURPOSE: Petrous apex cephaloceles (PACs) are uncommon lesions that are usually incidental but may be symptomatic. We reviewed MR and CT studies in 10 patients with PACs to identify characteristic imaging features that facilitate their diagnosis.

METHODS: MR and CT studies from 10 patients with PACs were reviewed retrospectively. In each case the PAC was characterized by lesion center, signal intensity or attenuation, adjacent petrous apex pneumatization, and its relationship to Meckel's cave. Intraoperative findings were reviewed in the three cases in which surgery was performed.

RESULTS: All 10 patients had lobulated expansile cystic petrous apex lesions centered along the posterolateral margin of Meckel's cave. All cysts were contiguous with Meckel's cave. Three patients had bilateral PACs. Four patients had symptoms that could potentially be explained by the PAC, while findings in the other six were incidental observations. Three patients underwent surgery, during which two lesions were diagnosed as meningoceles while the third was diagnosed as an arachnoid cyst protruding through a dural defect.

CONCLUSION: PACs represent a protrusion of meninges and CSF from the posterolateral portion of Meckel's cave into the petrous apex, which is their characteristic imaging appearance. PACs are usually incidental but may be symptomatic. Surgical intervention should be approached cautiously and undertaken only when symptoms are clearly linked to the presence of this lesion.

This article has been cited by other articles:

				S E J CONNOR, R LEUNG, and S NATAS Imaging of the petrous apex: a pictorial review Br. J. Radiol., May 1, 2008; 81(965): 427 - 435. [Abstract] [Full Text] [PDF]

				B. Schuknecht, D. Simmen, H.R. Briner, and D. Holzmann Nontraumatic Skull Base Defects With Spontaneous CSF Rhinorrhea and Arachnoid Herniation: Imaging Findings and Correlation With Endoscopic Sinus Surgery in 27 Patients AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 542 - 549. [Abstract] [Full Text] [PDF]

				Radiology Quiz Case 2: Diagnosis Arch Otolaryngol Head Neck Surg, November 1, 2006; 132(11): 1266 - 1267. [Full Text] [PDF]

				T. Motojima, K. Fujii, N. Ishiwada, J.-i. Takanashi, O. Numata, Y. Uchino, I. Yamakami, and Y. Kohno Recurrent Meningitis Associated With a Petrous Apex Cephalocele J Child Neurol, February 1, 2005; 20(2): 168 - 170. [Abstract] [PDF]