Skull Base Osteomyelitis 2, CT
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0296-Skull Base Osteomyelitis 2, CT
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CA0296-Skull Base Osteomyelitis 2, CT
Case ReportHistory
Exam
Prior Study
Findings
Extracranial soft tissues
There is general soft tissue swelling involving the nasopharynx, parapharyngeal, masticator, retropharyngeal and prevertebral spaces more on the left than right. There may be a 1 cm. localized fluid or pus collection inferior to the left petrous apex inferior surface just below the left carotid canal.
Sagging of the tongue and tongue base consistent with tongue weakness due to cranial nerve 12 involvement on the left.
General Skull Base
The basisphenoid and basiocciput (clivus) and the petrous apex inferior surface are eroded their marrow spaces infiltrated bilaterally. The floor of the middle cranial fossa is also eroded with its marrow space likely infiltrated on the left.
Cavernous sinus and Paracavernous Structures
There is no abnormal enhancement or structural abnormality and/or enlargement of cranial nerve 5 rootlets, ganglion or three divisions in the trigeminal cistern or in the paracavernous region. There is no cavernous sinus thrombosis or a cavernous carotid segment inflammation, occlusion and/or aneurysm.
Right and Left Temporal Bone
There is an erosive process spreading along the anterior-inferior aspect (extracranial aspect) of the petrous apex involving the bony Eustachian tube and carotid canal more on the left than right.
There is minimal mastoid mucosal disease/fluid without aggressive features. The temporal bones are otherwise normal.
Intracranial
There is no dural reactive or leptomeningeal enhancement. There is no definite dural reactive change along the floor of the middle cranial fossa or along the inner (intracranial) surfaces of the petrous portion of the temporal bone or clivus.
There is no subperiosteal, subdural or epidural abscess along the floor of the middle cranial fossa or along the inner (intracranial) surfaces of the petrous portion of the temporal bone or tentorium or falx cerebri.
There is no brain edema and/or evolving intracranial abscess present. There is no evidence of thrombosis, thrombophlebitis or other occlusive or inflammatory process of the sigmoid sinus, transverse sinus, the vein of Labbe’ or jugular bulb or vein. There is no inflammation of the distal internal carotid artery.
There is no obstructive hydrocephalus - either intra or extra ventricular or signs of raised intracranial pressure.
