Sigmoid sinus wall dehiscence
Left chronic otitis media for HRCT temporal bone evaluation to rule out underlying cholesteatoma.
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Lateral projection of the sigmoid sinus posterior the mastoid air cells resulting in rarefaction of the right occipital calvarium, a finding incidentally detected in this plain HRCT of temporal bones.
Sigmoid sinus wall dehiscence and diverticuli are a common etiology for pulsatile tinnitus especially when the wall dehiscence is seen anteriorly in relation to the mastoid temporal bone. The type of lateral rarefaction seen in this patient makes this patient susceptible for direct trauma as well as infection from local sources like the ear. The referring clinician was alerted of this potentially fatal anatomic variant.