Petrous apex cephalocele is a rare form of cephalocele centered typically in the postero-lateral part of Meckel's cave with variable extension into the petrous apex. They can be unilateral or bilateral, and usually, they are incidentally detected and are asymptomatic most of the times. Though they may present with sensorineural hearing loss.

In this case, the patient had hearing loss on the right. Some authors suggest that some symptomatic lesions require surgical intervention.

This case was kindly provided by Dr Rodrigo Dias Duarte.