Association of Venous Malformation of the Head and Neck with Meningoencephalocele: Report of 3 Cases

S. Salehian; N.J. Fischbein

doi:10.3174/ajnr.A2074

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Fig 1.
A, Coronal fast spin-echo T2-weighted image with fat suppression demonstrates herniation of gliotic brain parenchyma and meninges (black arrow) through a defect located in the left inferior temporal squamosa at the sphenotemporal junction. An adjacent ovoid T2 hyperintense structure (white arrows) was separate from the meningoencephalocele and represents a portion of a large left facial venous malformation. B, A more anterior coronal postgadolinium T1-weighted image with fat suppression demonstrates a homogeneously enhancing lobulated mass consistent with a venous malformation (white arrows), which extends from the suprazygomatic masticator space above (temporalis muscle [T]) to the mandible (M) below. C, Axial CT image demonstrates a bony defect in the inferior aspect of the temporal squamousa, with gliotic brain (small white arrows) and herniation of the meninges and subarachnoid space laterally (large white arrow). The adjacent venous malformation (V) is also indicated.
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Fig 2.
A, Coronal fast spin-echo T2-weighted image with fat saturation demonstrates inferior herniation of the left temporal lobe and subarachnoid space (short thick arrows), with distortion of the left temporal lobe but no frank gliosis. In addition, a portion of the patient's venous malformation is seen involving the nasopharynx (thin white arrows). B, Coronal CT image at a level similar to that in A reveals multifocal thinning of bone along the left greater wing of the sphenoid (small white arrows), as well as a focal defect in the inferior temporal bone (large white arrow). C, An axial CT image at the level of the upper neck shows additional areas of venous malformation (large white arrows), anterior to the sternocleidomastoid muscle (SCM) and containing phleboliths (small white arrows).
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Fig 3.
A, Coronal T1 postgadolinium image with fat saturation demonstrates cystic encephalomalacia of the left temporal lobe with a focal cephalocele (thin vertical arrows), as well as lobulated enhancing masses (large white arrows) consistent with a residual/recurrent venous malformation. B, An axial CT image in a bone window demonstrates loss of bone involving the left temporal squamosa (white arrows).