The Meckel cave: computed tomographic study. Part I: Normal anatomy; Part II: Pathology

Area of Science:

• Radiology
• Neurosurgery
• Anatomy

Background:

• The Meckel cave is a complex anatomical space at the base of the skull.
• Accurate imaging of the Meckel cave is crucial for diagnosing pathologies affecting the trigeminal nerve.

Purpose of the Study:

• To define the appearance of the normal Meckel cave using high-resolution computed tomography (CT).
• To evaluate the utility of high-resolution CT in diagnosing and determining the extent of Meckel cave lesions.

Main Methods:

• High-resolution CT scans of a formalin-fixed cadaver head were performed in multiple planes.
• Correlation with anatomic dissection and cross-sections.
• CT imaging with contrast enhancement in normal patients.
• Review of CT findings in 13 patients with Meckel cave lesions.

Main Results:

• High-resolution CT allowed consistent and accurate definition of the Meckel cave, trigeminal nerve, and adjacent structures.
• CT identified various lesions including schwannomas, meningiomas, secondary tumors, glioma, and a congenital fatty tumor.
• Surgical confirmation was obtained in 11 of the 13 reviewed cases.

Conclusions:

• High-resolution CT is an effective tool for the diagnosis and assessment of Meckel cave lesions.
• This imaging modality facilitates precise determination of lesion extent and aids surgical planning.