Hyperpneumatisation of mastoid air cells

Case contributed by Townsville radiology training
Diagnosis certain

Presentation

Two month history of swelling in the right occipital region with two weeks of tenderness. No new headaches, trauma, or discharge. No fever. No alteration in level of consciousness. Background of benign intracranial hypertension and obesity. Repetitive valsalva maneuver as a habit.

Patient Data

Age: 16 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Excessive pneumatization of the mastoid air cells extending along occipital bone including condyle, clivus, and right petrous apex. Loculated and septated air collection in the parieto-occipital scalp.

It also extends into the mandibular fossa, prevertebral, and parotid spaces.

Air pockets extending to extradural space at the craniovertebral junction, anterior to occipital condyle and through hypoglossal canal. Loculated septated collection in extradural space in parieto-occipital region causing mass effect on brain parenchyma.

The partial empty sella syndrome (type 1) and cerebrospinal fluid along optic nerve sheaths is a well known association with benign intracranial hypertension.

No pneumocephaly.

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