Purpose or Case Report: 1) Review the normal development and anatomy of the posterior skull base.
2) Describe the variety of pathologies affecting the posterior cranial fossa in the pediatric age group with a focus on the typical computed tomography (CT) and magnetic resonance imaging (MRI) characteristics.
3) Discuss clinical management and imaging follow up of posterior cranial fossa pathology.
Methods & Materials: We reviewed skull base imaging including brain CT and MRI for pediatric patients from age 0 to 18 years. This exhibit will review the clinical presentation of posterior skull base lesions, typical and atypical locations and etiologies. Classic and unique cases will be presented with particular emphasis on CT and MRI imaging findings.
Results: The posterior skull base is predominantly formed by the occipital and temporal bones with the clivus forming the anterior border. Key anatomic locations in the posterior fossa include the clivus, petrous bone (including the middle and inner ear), petrous apex, mastoid air cells, and canals/foramina (jugular canal, hypoglossal canal, internal auditory canal, mastoid foramina and foramen magnum). Entities involving the anterior cranial fossa can be classified as:
1) Congenital pathologies affecting the posterior skull base, including occipital encephaloceles.
2) Traumatic lesions involving the craniovertebral junction.
3) Malignancies including clival chordoma, chondrosarcomas, and tumors involving the clivus.
4) Benign lesions including fibro-osseous disease, meningiomas, paraganglioams and schwannomas.
5) Infectious etiologies including osteomyelitis.
Conclusions: Knowledge of normal development of the skull base is essential in pediatric patients to avoid over diagnosis as malignant and aggressive lesions are less frequent when compared to the adult population. This exhibit will explore the array of posterior skull base pathology in the pediatric patient population with focus on the particular CT and MR imaging characteristics.