Citation, DOI, disclosures and article data
Citation:
Goel A, Gaillard F, Deng F, et al. Petrous apex cephalocele. Reference article, Radiopaedia.org (Accessed on 13 May 2024) https://doi.org/10.53347/rID-28262
Disclosures:
At the time the article was last revised Frank Gaillard had the following disclosures:
- Radiopaedia Australia Pty Ltd and Radiopaedia Events Pty Ltd, Director, Founder and CEO (Radiopaedia) (ongoing)
- Biogen Australia Pty Ltd, Investigator-Initiated Research Grant for CAD software in multiple sclerosis: finished Oct 2021 (past)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Frank Gaillard's current disclosures
Petrous apex cephalocele is a rare form of cephalocele centered typically in the posterolateral part of Meckel cave with variable extension into the petrous apex. They can be unilateral or bilateral (commoner).
There may be a slight female predilection.
The lesions are incidentally detected and are asymptomatic most of the time. However, they may present with trigeminal neuralgia, trigeminal neuropathy (facial numbness), headache, CSF otorrhea, or hearing loss 1.
Associations
Recognized associations of petrous apex cephaloceles include
CT
- homogeneously low density area is noted in the petrous apex with sharply defined margins
MRI
MRI can demonstrate the continuation with Meckel cave and hence helps in providing a confident diagnosis thereby preventing unnecessary surgical intervention. The signal intensities follow that of CSF.
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T1: hypointense
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T2: hyperintense
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FLAIR: typical CSF suppression
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DWI: no restriction
As a general differential consider
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1. Moore KR, Fischbein NJ, Harnsberger HR et-al. Petrous apex cephaloceles. AJNR Am J Neuroradiol. 2001;22 (10): 1867-71. Pubmed citation
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2. Razek AA, Huang BY. Lesions of the petrous apex: classification and findings at CT and MR imaging. Radiographics. 2012;32 (1): 151-73. doi:10.1148/rg.321105758 - Pubmed citation
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3. Stark TA, McKinney AM, Palmer CS et-al. Dilation of the subarachnoid spaces surrounding the cranial nerves with petrous apex cephaloceles in Usher syndrome. AJNR Am J Neuroradiol. 2009;30 (2): 434-6. doi:10.3174/ajnr.A1283 - Pubmed citation
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