Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2021
ReviewImaging Anatomy and Pathology of the Intracranial and Intratemporal Facial Nerve.
The facial nerve is one of the most complex cranial nerves, with motor, sensory, and parasympathetic fibers. A large spectrum of congenital, inflammatory, vascular, and neoplastic processes may affect one or more segments of the nerve. Customized use of computed tomography and magnetic resonance imaging combined with good understanding of the nerve anatomy and relevant clinical/surgical key points is crucial for appropriate assessment of facial neuropathy. This article reviews the anatomy of the intracranial and intratemporal facial nerve, and the imaging features of the most frequent disorders involving those segments of the nerve.
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The petrous apex may be affected by a range of lesions, commonly encountered as incidental and asymptomatic findings on imaging performed for other clinical reasons. Symptoms associated with petrous apex lesions commonly relate to mass effect and/or direct involvement of closely adjacent structures. Petrous apex lesions are optimally assessed using a combination of high-resolution CT and MRI of the skull base. Management of petrous apex lesions varies widely, reflecting the range of possible pathologies, with imaging playing a key role, including lesion characterization, surveillance, surgical planning, and oncological contouring.
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The skull base is a critical structure in the craniofacial region, supporting the brain and vital facial structures in addition to serving as a passageway for important structures entering and exiting the cranial cavity. This paper will review and highlight some of the embryology, developmental anatomy, including ossification, and related abnormalities of the anterior, central and posterior skull base using illustrative cases and tables. Pathologies such as dermoids/epidermoids, cephaloceles, nasal gliomas, glioneuronal heterotopias, various notochordal remnants, persistent craniopharyngeal canal, teratomas, platybasia, basilar invagination, clival anomalies and Chiari malformations will be discussed. Developmental pearls and pitfalls will also be highlighted.
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Neuroimaging Clin. N. Am. · Nov 2021
ReviewAnterior and Central Skull Base Tumors: Key Points for the Radiologist to Analyze Prior to Endoscopic Approaches.
Initially developed as a minimally invasive technique to approach inflammatory conditions, transnasal endoscopic surgery has progressively expanded its anatomic targets and clinical indications. Consequently, numerous surgical approaches to the anterior and central skull base were developed, referred to as extended endonasal approaches (EEA). The intrinsic advantage of EEA is the exploitation of a natural corridor provided by sinonasal airspaces, with no need for skin incision and osteotomy and limited soft tissue damage. In this context, imaging plays essential role, demonstrating the relevant anatomic relationships of the lesion, the proper surgical corridor, the anatomic variants that may increase the surgical risk.
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Neuroimaging Clin. N. Am. · Nov 2021
ReviewNeurosurgical Approaches to the Skull Base: A Guide for the Radiologist.
Skull base surgery relies on the assessment of detailed neuroimaging studies to assist with surgical planning. We review typical neuroimaging features associated with common neurosurgical skull base approaches, highlighting relevant imaging anatomy and pertinent postoperative imaging appearances.