Clinical question to be answered:Evaluate face and brain. Signs and symptoms: Term infant with facial dermal cyst versus meningocele. Technique:1 mm axial images of the entire craniofacial region without infusion of contrast material were obtained. 3-D reformatted images of the bony structures and soft tissues were obtained. Sagittal and coronal 2-D reformatted images were also obtained for evaluation. Examination demonstrates a small defect in the midline at the level of cribriform plate anteriorly. CSF density appears to extend across this defect and extends inferiorly posterior to the nasal bridge and eventually terminates into a low density collection in the midline in the subcutaneous tissues of the nose. The collection measures approximately 14 mm in cranial/cephalad axis and 7-mm in AP axis.This finding is consistent with a meningocele. This finding is best appreciated on the 2-D reformatted images in all 3 axial, sagittal and coronal planes. Further evaluation with an MRI examination may assess for detection of possible presence of neural tissue within the meningocele or along its tract. Cisternography is also a helpful study for disk evaluation.Both on sagittal and coronal 2-D reformatted images there is a suspected small amount of tissue within the tract and a meningocele.This examination is otherwise unremarkable.All appropriate 3-D reformatted measurements are submitted in patient's radiology 5.
Midline anterior bony defect at the level of cribriform plate with an associated meningocele as described above.