Occult Malformations of the Skull Base

Petrous apex cephalocele and empty sella-arachnoid cyst coexistence: a clue for cerebrospinal fluid pressure inbalance?

“…It is usually an asymptomatic incidental finding in adults. However, it should be considered as a possible cause of CSF rhinorrhea, otorrhea, and recurrent meningitis in children (3)(4)(5). The smallest patient diagnosed in the literature was 2-year-old.…”

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

“…The reasons for admission were recurrent meningitis, postural headache and transmission-type hearing loss. 1,8,[16][17][18] Only one of the patients in the paediatric group had no CSF leakage. 9 Although other theories have also been suggested, spontaneous CSF leakage is believed to arise from defects in the skull base as a result of the increase in ICP.…”

“…Coexistence of PAC and rhinorrhoea has only been reported in paediatric patients in the literature. 1,[16][17][18] This is the first time that this coexistence is being reported in adult patients. The patient had bilateral PAC, and previous meningitis was present in her history.…”

Spontaneous encephaloceles of the temporal lobe

“…Although the tegmen tympani remains the more common location for temporal bone encephaloceles, 16,31,46,53 lesions involving the mastoid cavity as well as the petrous apex have been described in the literature. 34,35,45 Although middle ear effusions, recurrent ear infections, and progressive hearing loss are the most common findings at presentation, cases of medically refractory temporal lobe epilepsy have also been reported in association with posteroinferior encephaloceles. 31,46,57 …”