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Petrous apex cephaloceles.

K R Moore1, N J Fischbein, H R Harnsberger

  • 1Department of Radiology, University of Utah School of Medicine, Salt Lake City 84132, USA.

AJNR. American Journal of Neuroradiology
|December 6, 2001
PubMed
Summary
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Petrous apex cephaloceles (PACs) are uncommon CSF-filled sacs originating from Meckel's cave. Imaging reveals characteristic cystic lesions, often incidental but sometimes symptomatic, requiring cautious surgical consideration.

Area of Science:

  • Neurosurgery
  • Radiology
  • Neuroimaging

Background:

  • Petrous apex cephaloceles (PACs) are rare lesions.
  • PACs can be asymptomatic or symptomatic.

Observation:

  • Retrospective review of MR and CT scans in 10 patients with PACs.
  • Characterization of PACs based on location, signal intensity/attenuation, and relationship to Meckel's cave.
  • Intraoperative findings reviewed for 3 surgically treated cases.

Findings:

  • All PACs were lobulated, expansile, cystic lesions centered posterolaterally in Meckel's cave.
  • Lesions were contiguous with Meckel's cave, with 3 bilateral cases.
  • Two lesions were meningoceles, and one was an arachnoid cyst protruding through a dural defect.

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Implications:

  • PACs represent meningeal and CSF protrusions from Meckel's cave into the petrous apex.
  • Diagnosis relies on characteristic imaging features.
  • Surgical intervention should be reserved for clearly symptomatic cases.