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Radiology News


Petrous Apex Cephaloceles-MRI

64 yr old female with non specific h/o headache.MRI scan (axial T1 and T2) showed well defined cystic lesions at both petrous apices with no surrounding edema, NCCT (not shown) showed no bony destruction.Sag T2 showed partial empty sella, however other signs of pseudo-tumor cerebri such as papilledema and prominent CSF around optic nerves was not seen. Both lesions were in direct continuity with meckel's cave. These are B/L petrous apex cephaloceles.  Case by : Dr Prashant Gupta  and Dr Himani Agarwal, Consultant Radiologists.

Learning points:
- not true "cephaloceles" as they do not contain brain tissue.
- actually they are herniation of posterolateral meckels cave into anteromedial petrous apex.
- etiology is debatable but said to be due to increased CSF pulsations.
- rare case reports of association with partial empty sella(as seen here)
- one of the "do not touch" petrous apex lesions

Petrous Apex Cephaloceles-MRI Reviewed by Sumer Sethi on Friday, February 03, 2012 Rating: 5

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