The aim of this paper is to stress the importance of cautious evaluation of Meckel's cave when interpreting brain or neck CT and/or MRIs. Anatomy and normal imaging findings are reviewed with discussion about imaging modalities used in evaluation of trigeminal cavity. Various pathological conditions found in the Meckel's cave and their imaging features are also described.

Meckel's cave (MC) or trigeminal cavity (TC) is situated on the anterior side of the petrous temporal bone near its apex. It is a cerebrospinal fluid-filled structure wedged between meningeal and periostal dural layers and represents extension of the posterior fossa meningeal dura into the middle fossa. With its shape resembling open-ended three-fingered glove, Meckel's cave accompanies trigeminal nerve (CN V) into the middle cranial fossa and contains trigeminal (Gasserian) ganglion with its postganglionic trigeminal rootlets (ophthalmic (V1), maxillary (V2) and mandibular (V3) nerve) that...

The preferred imaging modality in depicting structure, contents and relationship of Meckel's cave with adjacent structures is MRI, using protocol that includes high-resolution sequences in three planes. High-resolution heavily T2-weighted volumetric sequences are used to explore the cisternal course of the cranial nerves, Gasserian ganglion (GG) and trigeminal rootlets within MC. High resolution T1-weighted fat-suppressed imaging with and without contrast injection depicts fat planes at the skull base, characterizes and localizes lesions, visualizes bone marrow invasion, meningeal invasion and perineural spread. Meckel's cave presents as...

Despite being a small anatomical site, Meckel's cave is an important gateway into the other regions of the skull base and a pathway in perineural spread for numerous pathological conditions. Some TC lesions can be asymptomatic, which, along with still not fully understood precise meningeal architecture and deep, not easily accessable location of the MC with surrounding neurovascular structures, makes diagnosing the conditions of this area challenging. However, thorough and routine analysis of this region combined with knowledge about most common pathological entities can assist...

M. Prenc: Nothing to disclose M. Mestrovic: Nothing to disclose M. Smoljan: Nothing to disclose

Janjua RM, Al-Mefty O, Densler DW, Shields CB. Dural relationships of Meckel cave and lateral wall of the cavernous sinus. Neurosurg Focus. 2008;25(6) Landry M. Konan, Oka,Alban Slim Mbende,F. Kouakou,S. Velut. Microanatomy of the trigeminal cavum: Meckel's cave. Anatomy journal of Africa. 2019; 8 ChotaiA., Abdelgalil A. Is Meckel's cave routinely evaluated by Northern Deanery radiology trainees? Clinical Radiology. 2019; 74 (2). Arslan M, Deda H, Avcı E , Elhan A, Tekdem I , Tubbs R.S. et al. Anatomy of Meckel’s Cave and the Trigeminal...