Objective: The posterior skull base can house a range of pathologic processes that can extend
beyond the skull base, both intracranially and caudally. These pathologies can be
broadly subdivided into neoplastic, vascular, infectious or trauma-related. Understanding
the complex anatomy and imaging features of posterior skull base lesions are important
for the skull base surgeon to understand how best to guide management.
Purpose: The purpose of this abstract is to highlight normal anatomy and pathology of the
posterior skull base and present cross sectional imaging review of the pathologies
that may be encountered by the skull base surgeon.
Methods: We performed a retrospective search of our radiology database using the Nuance mPower
search engine for cases involving the posterior skull base from 2010 to 2021. Both
CT and MRI images and clinical information from EHR were reviewed.
Results: CT and MRI are used as complementary methods to analyze the posterior skull base.
Multiple imaging examples were used in this pictorial essay to illustrate the relevant
anatomy and pathology of the posterior skull base for clinical and surgical management.
Conclusion: Imaging plays an essential role in the diagnosis and management of posterior skull
base pathologies. Understanding normal anatomy, its variations and pathology of the
posterior skull base can be critically important in the clinical and surgical management
of the patient ([Figs. 1] and [2]).[1]-[5]
Fig. 1 Coronal CT in bone window shows a well-defined tubular lesion extending from the
jugular foramen region into the middle ear cavity anterior to the cochlear promontory.
Fig. 2 Coronal MRA MIP image shows a more laterally located and diminutive left ICA consistent
with an aberrant ICA. Knowledge of anatomic variants and imaging findings are important
to prevent unnecessary or fatal (biopsy) management.
