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Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm

Central skull base osteomyelitis is a rare entity that can demonstrate confounding radiologic, clinical, and laboratory data leading to a delay in diagnosis. The morbidity and mortality for skull base osteomyelitis are both high, thus a rapid diagnosis is required for appropriate treatment. In this...

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Autores principales: Kristenson, Scott, Jackson, Adam, Mendoza, Yolanda M., Fullmer, Christina, Boldt, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338986/
https://www.ncbi.nlm.nih.gov/pubmed/32670451
http://dx.doi.org/10.1016/j.radcr.2020.05.069
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author Kristenson, Scott
Jackson, Adam
Mendoza, Yolanda M.
Fullmer, Christina
Boldt, Brian
author_facet Kristenson, Scott
Jackson, Adam
Mendoza, Yolanda M.
Fullmer, Christina
Boldt, Brian
author_sort Kristenson, Scott
collection PubMed
description Central skull base osteomyelitis is a rare entity that can demonstrate confounding radiologic, clinical, and laboratory data leading to a delay in diagnosis. The morbidity and mortality for skull base osteomyelitis are both high, thus a rapid diagnosis is required for appropriate treatment. In this case report, we discuss a 68-year-old male who presented with acute left facial nerve paralysis in the setting of chronic headache and left mucoid middle ear effusion. Radiologic evaluation revealed abnormal hypointense marrow of the central skull base on T1 weighted magnetic resonance imaging, preclival mass-like tissue, and short segment luminal narrowing of the left cervical ICA with mycotic aneurysm formation. Extensive workup via a multidisciplinary approach, including neurology, otolaryngology, neurosurgery and radiology led to a diagnosis of central skull base osteomyelitis. A familiarity of this disease process is important for the radiologist in order to facilitate appropriate patient referral and treatment. This case emphasizes the importance of considering this diagnosis in the setting of headache, cranial neuropathy, and abnormal skull base imaging with adjacent preclival soft tissue mass.
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spelling pubmed-73389862020-07-14 Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm Kristenson, Scott Jackson, Adam Mendoza, Yolanda M. Fullmer, Christina Boldt, Brian Radiol Case Rep Head and Neck Central skull base osteomyelitis is a rare entity that can demonstrate confounding radiologic, clinical, and laboratory data leading to a delay in diagnosis. The morbidity and mortality for skull base osteomyelitis are both high, thus a rapid diagnosis is required for appropriate treatment. In this case report, we discuss a 68-year-old male who presented with acute left facial nerve paralysis in the setting of chronic headache and left mucoid middle ear effusion. Radiologic evaluation revealed abnormal hypointense marrow of the central skull base on T1 weighted magnetic resonance imaging, preclival mass-like tissue, and short segment luminal narrowing of the left cervical ICA with mycotic aneurysm formation. Extensive workup via a multidisciplinary approach, including neurology, otolaryngology, neurosurgery and radiology led to a diagnosis of central skull base osteomyelitis. A familiarity of this disease process is important for the radiologist in order to facilitate appropriate patient referral and treatment. This case emphasizes the importance of considering this diagnosis in the setting of headache, cranial neuropathy, and abnormal skull base imaging with adjacent preclival soft tissue mass. Elsevier 2020-07-04 /pmc/articles/PMC7338986/ /pubmed/32670451 http://dx.doi.org/10.1016/j.radcr.2020.05.069 Text en Published by Elsevier Inc. on behalf of University of Washington. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Head and Neck
Kristenson, Scott
Jackson, Adam
Mendoza, Yolanda M.
Fullmer, Christina
Boldt, Brian
Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title_full Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title_fullStr Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title_full_unstemmed Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title_short Central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
title_sort central skull base osteomyelitis manifesting with a preclival mass and internal carotid artery mycotic aneurysm
topic Head and Neck
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338986/
https://www.ncbi.nlm.nih.gov/pubmed/32670451
http://dx.doi.org/10.1016/j.radcr.2020.05.069
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