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Lateral sphenoid cephalocele

Case contributed by Johan Gräbe
Diagnosis probable

Presentation

Gradual loss of visual acuity in the left eye.

Patient Data

Age: 65 years
Gender: Female

Past surgical history included previous retinal surgery performed on the right eye, details not provided.

Greater wing of left sphenoid bone expansion containing low density material (20 HU).

Associated narrowing of the ipsilateral superior and inferior orbital fissures as well as the left foramen rotundum and pterygopalatine fossa.

The post-surgical changes and drainage device in the right eye are unrelated to this clinical presentation.

Calcification of periodontal ligaments noted incidentally.

Case Discussion

Arachnoid pits seen in this case may have contributed to the formation of a left lateral sphenoid cephalocele 1.

Sphenoid arachnoid pits without the presence of a cephalocele is a differential diagnosis to consider. MRI can be used to distinguish between these diagnoses. This patient, unfortunately, did not go for an MRI.

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