E4949. Case-Based Review of Meckel's Cave: Anatomy, Variations, and Pathologies
  1. Bilal Battal; Department of Radiology, Neuroradiology Division, University of North Carolina
  2. Carlos Zamora; Department of Radiology, Neuroradiology Division, University of North Carolina
Meckel's Cave (MC) is a CSF-containing pouch within the middle cranial fossa that communicates with the prepontine subarachnoid space and houses the trigeminal nerve and ganglion. CT and MRI are essential tools for evaluating the anatomy, variations, and different pathologies affecting the MC. In addition to a comprehensive understanding of its anatomy, knowledge of the clinical context and relevant imaging features associated with common pathologies are imperative for an accurate diagnosis.

Educational Goals / Teaching Points
This exhibit will explore and outline the normal anatomy of the MC and vital adjacent structures. We will utilize a case-based approach to illustrate a large spectrum of pathologies, including infection, inflammatory processes, and tumors involving the MC. We will also highlight key CT and MRI findings to aid in the diagnosis or exclusion of common pathologies of the MC.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This section reviews MC's anatomy and variations (aplasia/hypoplasia, enlargement), pathologies including infections, tumors (trigeminal schwannoma, meningioma, metastasis, perineural tumor spread, neurofibromas, pituitary macroadenoma, epidermoid and dermoid cysts, chordoma, and chondrosarcoma), as well as inflammatory processes (neurosarcoid, pseudotumor) that can directly affect the MC or extend from nearby structures.

Imaging plays a pivotal role in the evaluation of MC. Familiarity with key imaging findings enables the radiologist to make an accurate diagnosis in lesions with distinctive features or narrow down the differential diagnoses in more complex cases. This educational exhibit offers an interactive overview of MC lesions and provides insights into their assessment using CT and MRI.