Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Sign up to receive an email alert when a new Case of the Week is posted.
September 5, 2011
Bilateral Petrous Apex Cephaloceles (PACs)
- PACs are congenital or acquired herniations of the posterolateral wall of the Meckel's cave into the petrous apex.
- Key Diagnostic Features: CT or MR imaging demonstrates CSF density/intensity lesions within enlarged, prominent Meckel's cave(s). These lesions typically extend postero-laterally into the petrous apices. Secondary bony scalloping of the petrous apex can be seen.
- PACs are usually incidental findings. If complicated, symptoms suggestive of trigeminal neuralgia, CSF otorrhea, and recurrent meningitis have been reported.
- DDx: congenital cholesteatoma, cholesterol granuloma, mucocele, petrous apicitis and trigeminal schwannoma.
- Rx: "Leave-me-alone" lesions. Surgery can be considered if PACs are associated with complications.
Current Issue
Case Collections
