The association between petrous apex cephalocele and empty sella

Abstract

PAC is associated with empty sella, and both lesions are probably related to the same cause.

Cavum trigeminale cephalocele associated with intracranial hypertension in an 18-month-old child: illustrative case

“…Previous publications reported on how impaired CSF dynamics and increased ICP could lead to herniation of meninges and CSF into the sella turcica and the petrous apex. 3,10,11 In our patient, venous disease may have played a major role in inducing intracranial hypertension, as suggested by the absence of signal in the venous sinuses on MRI. However, we think that venous obstruction may be, at least in part, secondary to distortion of the venous anatomy secondary to intracranial hypertension: Venous obstruction further increases venous pressure, CSF pressure, and ICP in a vicious cycle.…”

“…Among symptomatic cases, headache, trigeminal neuralgia, CSF leak, vertigo, ataxia, facial numbness, hearing loss, diplopia, and other visual disturbances have been described. 3,6,9,10,13 Our patient was referred to us with irritability, failure to thrive, drowsiness, vomiting, and left cranial nerve VI palsy. To our knowledge, he represents the youngest patient diagnosed with CTC to date.…”

Bilateral Petrous Apex Cephaloceles and Skull Base Attenuation in Setting of Idiopathic Intracranial Hypertension

“…The association between PACs and elevated intracranial pressures is less well described; however, the previously described coexistence of PACs and empty sella supports the possible role of altered CSF dynamics in the former condition (2). Similarly, the relation between SSCD and elevated intracranial pressure is incompletely understood, but recent data demonstrate an association between obesity, OSA, and SSCD, suggesting that intracranial hypertension may also contribute to SSCD (4).…”

“…Although they are usually incidental findings, they have been reported in association with cerebrospinal fluid (CSF) leaks, tinnitus, trigeminal neuralgia, vertigo, recurrent meningitis, and headaches (1). While the exact etiology remains unclear, the most widely accepted theory is that increased intracranial pressure leads to herniation of both meninges and CSF from the posterolateral portion of Meckel's cave (2). Herein, we report a unique case of an obese female patient with bilateral PACs as well as bilateral encephaloceles, superior semicircular canal dehiscence (SSCD), and empty sella.…”

Recurrent meningitis in a child with bilateral cochlear implantation associated with a petrous apex encephalocele: a case report and literature review

“…Several other groups have reported the radiographic incidence of PACs without reporting clinical histories (Table 2) [31][32][33] including one large study by Jamjoom and Alorainy who identified 111 PACs in 2410 brain MRIs leading to an estimate of 5.3% incidence of PACs in their cohort. [34] We describe a case of a pediatric patient with a petrous apex encephalocele leading to a CSF leak and recurrent meningitis in the setting of bilateral cochlear implantation. To our knowledge, there are no previous cases in the English literature involving a patient with a PAC and cochlear implantation.…”