Petrous apex cephalocoele: contribution of coexisting intracranial pathologies to the aetiopathogenesis

Çavuşoğlu, Mehtap; Duran, Semra; Hatipoğlu, Hatice Gül; Cılız, Deniz; Elverici, Eda; Sakman, Bülent

doi:10.1259/bjr.20140721

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Arachnoid cyst is often asymptomatic and fortuitously discovered. sometimes it can be revealed by trigeminal neuropathy with neuralgia or paraesthesia and headache such as in our observation or responsible of leakage of cerebrospinal fluid in the form of otorrhea that is manifested by sensorineural hearing loss and may necessitate surgical treatment [3]. This pathological entity is often bilateral and encountered in female population.…”

Section: Generalitiessupporting

confidence: 51%

“…It is usually associated with empty Sella, such as in our observation and especially in several reports suggesting the same etiopathogenesis [4] [5]. The most widely accepted theory is that of altered cerebrospinal fluid dynamics with increased intracranial pressure which subsequently leads to herniation of meninges and cerebrospinal fluid from the posterolateral portion of Meckel's cave into the petrous apex [3] [4] [6] [7].…”

Section: Etiopathogenesismentioning

confidence: 62%

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Unusual Cause of Trigeminal Neuralgia: Arachnoid Cyst of Petrous Apex

Fakir¹,

Ouha²,

Zouine³

et al. 2019

OALib

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Arachnoid cyst of petrous apex is an uncommon cyst lesion that herniates from the posterolateral portion of the Meckel's cave into the petrous apex. It can be unilateral or bilateral, usually observed in female population. Its etiopathogenesis is still uncertain and many theories were reported in the literature. The characteristic imaging appearance, topography and benign behavior of the lesion allow to differentiate arachnoid cyst from other cyst-like lesions of petrous apex and prevent abusive surgery or unnecessary investigations. The purpose of this study is to illustrate through this observation the role of sectional imaging in the diagnosis of symptomatic arachnoid cyst of petrous apex.

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Section: Generalitiessupporting

confidence: 51%

Section: Etiopathogenesismentioning

confidence: 62%

Unusual Cause of Trigeminal Neuralgia: Arachnoid Cyst of Petrous Apex

Fakir¹,

Ouha²,

Zouine³

et al. 2019

OALib

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“…Some previous reports describe that PAC may produce the clinical manifestation related to a CSF fistula. 1 , 4 , 11 , 12 , 13 The lesion triggered a CSF fistula in these patients when a tear occurred in the cyst wall, allowing CSF to leak into the petrous apex. PAC of our patient may be the possible source of the CSF leak.…”

Section: Discussionmentioning

confidence: 99%

Unilateral expanding petrous apex cephalocele and contralateral vitreous hemorrhage in a young patient with intracranial hypertension

Hanai

Hashimoto

Nakamura

2022

American Journal of Ophthalmology Case Reports

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Purpose To report a case of unilateral petrous apex cephalocele (PAC) and contralateral vitreous hemorrhage in a young patient with intracranial hypertension. Observations A 12-year-old boy had acute visual loss in the right eye. The clinical and radiological findings were consistent with right vitreous hemorrhage with mild intracranial hypertension and left PAC. Cerebral angiography demonstrated low flow of the left inferior petrosal sinus and anterior venous high flow from the cavernous sinus to the facial vein via the superior ophthalmic vein. The presence of an expanding PAC, blocking the venous flow away from the inferior petrosal sinus, would produce an ipsilateral intraocular pressure (IOP) (20 mmHg) mildly higher than the other one (16 mmHg) although it is in the normal range, which may have caused the difference of the translaminar pressure gradient resulting from the balance between the cerebrospinal flow pressure and the IOP. Conclusion and Importance Unilateral expanding PAC may cause intracranial hypertension with different severity of papilledema between two eyes.

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“…Case reports have described PAC with symptoms that range from cranial nerve neuralgias to incidental findings on imaging. CSF otorrhea and rhinorrhea has been reported in the pediatric population, with sequela of meningitis, tinnitus, and hearing loss (2,4).…”

Section: Discussionmentioning

confidence: 99%

Petrous Apex Cephaloceles: Radiology Features and Surgical Management of a Rare Entity

Epsten

Koçak²,

Beer‐Furlan

et al. 2021

Otology &Amp; Neurotology

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Objective:To characterize the radiologic findings of petrous apex cephalocele (PAC) in a patient cohort, and report the surgical management for three symptomatic PAC patients and cerebrospinal fluid (CSF) leak via the middle cranial fossa approach.Study Design:Retrospective case series.Setting:Academic center.Patients:Thirty-five patients with PAC were identified by review of the imaging archive between 2008 and 2019 (29 females; mean, 55 yrs; range, 4–86 yrs). All patients underwent magnetic resonance imaging of the skull base and/or computed tomography examination.Intervention(s):Surgical repair of PAC.Main Outcome Measure(s):Radiologic features of PAC.Results:Radiological features of PAC: 25.7% bilateral; partial or expanded empty sella in 82.9%; arachnoid pits in 14.2%; and enlarged CSF space of optic nerve sheath in 20.0%. Coexisting pathology included temporal, sphenoid, and bilateral jugular foramen meningocele; as well as cribriform, middle crania fossa, and right temporal defect. Three case studies describing the surgical course of spontaneous CSF leak secondary to PAC were managed with the middle cranial fossa approach.Conclusions:PAC is an exceedingly unusual cause for CSF leak in the adult and pediatric population. A middle fossa approach may be used to treat CSF leak as a result of PAC. Typically, CSF otorrhea originates from an encephalocele that extends via a bony defect in the tegmen tympani or tegmen mastoideum. However, on occasion the source of the CSF otorrhea is not via the tegmen, instead defects in the middle fossa floor, medial to the ridge for the gasserian ganglion (tubercle of Princeteau), need to be considered.

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Petrous apex cephalocoele: contribution of coexisting intracranial pathologies to the aetiopathogenesis

Cited by 8 publications

References 22 publications

Unusual Cause of Trigeminal Neuralgia: Arachnoid Cyst of Petrous Apex

Unusual Cause of Trigeminal Neuralgia: Arachnoid Cyst of Petrous Apex

Unilateral expanding petrous apex cephalocele and contralateral vitreous hemorrhage in a young patient with intracranial hypertension

Petrous Apex Cephaloceles: Radiology Features and Surgical Management of a Rare Entity

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