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Petrous Apex Granulomas: CT and MR Imaging

Published online by Cambridge University Press:  14 September 2018

Stephen Hentschel
Affiliation:
Division of Neurosurgery, Department of Surgery, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver BC Canada
Felix Durity*
Affiliation:
Division of Neurosurgery, Department of Surgery, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver BC Canada
*
Felix Durity, Room 300C-700 West 10th Avenue, Vancouver, BC Canada V5Z 4E5
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A 29-year-old male complained of a four month history of horizontal, spontaneous, and nonprogressive diplopia. On examination he had a mild left sixth nerve palsy. The rest of his general and neurologic examinations were normal.

Computed tomography scanning demonstrated a nonenhancing, well-circumscribed, lesion in the left petrous apex (Figure 1). The opposite apex was well pneumatized. The lesion abutted the medial wall of the horizontal canal of the internal carotid artery and pointed towards the lateral wall of the sphenoid sinus. Unfortunately, CT bone windows were not available for this case but would have been helpful in terms of the differential diagnosis. An MRI demonstrated a predominantly high signal mass on T1 and T2 sequences (Figure 2). The diagnosis was a petrous apex granuloma.

Type
Neuroimaging Highlight
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

References

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