A rare intracranial complication of cholesterol granuloma

A Case of Temporal Bone Cholesterol Granuloma Extending to Posterior Cranial Fossa without Middle Ear Involvement

“…Most cases of invasion into the cranial fossa are cholesterol granulomas in the petrous apex, and cranial involvement of the middle ear and mastoid region are infrequently observed. [3][4][5] The case discussed in this report is quite rare, as unlike in previous cases, no otologic symptoms nor middle ear involvement were observed. Conductive hearing loss can occur in patients with cholesterol granulomas in the middle ear, and cranial nerve impairment, including sensory neural hearing loss and facial palsy, can accompany cholesterol granulomas in the petrous apex.…”

“…2) Involvement of the cranial fossa may cause neurologic symptoms such as headache, insomnia, and abnormal behavior. 2,3,5) Considering the known aggressive progression of the disease, we presumed that these neurological symptoms would have occurred if the mass was left untreated. Our patient was treated prior to the onset of symptoms and recovered without complications.…”

“…In previous cases of cholesterol granuloma with intracranial involvement, some have reported re-pneumatizing the temporal bone through drainage and ventilation of the cyst, 1) although some of these cases also reported cholesterol granuloma recurrence. 2,3) In most cases, complete resection of the cyst was performed. [3][4][5]8,10,13) Complications, such as bleeding and dura injury due to excessive dissection, can occur necessitating meticulous surgical technique.…”

Mastoid cholesterol granuloma: a case presentation

“…A case of large extradural collection of fluid due to cholesterol granuloma was reported. 6 Initial radiological investigation is performed by temporal bone CT scan, however CT appearance may be indistinguishable from those of cholesteatoma. The MRI characteristic of CG is helpful for its differentiation from cholesteatoma or other diseases.…”

Cholesterol granuloma of the temporal bone: a pathologic designation or a clinical diagnosis?

“…Small asymptomatic cholesterol granulomas of the petrous apex should not be operated on, but instead followed up on a yearly basis with CT and MRI. A few complications, such as facial nerve paralysis, spontaneous cerebrospinal fluid otorrhea and involvement of the middle cranial fossa, have been reported [13,51,52].…”