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A retrospective review was completed of high-resolution axial T2WI for internal auditory canal protocol imaging. The presence and laterality of middle cranial fossa pits (small bony defects containing CSF) and encephaloceles (brain parenchyma protrusion through osseous defects with or without bony remodeling) were recorded. A total of 203 patients were included in the final cohort; 106 (52.2%) were women. Forty-five (22.2%) patients had middle cranial fossa pits: 14 (31.1%) unilateral on the right, 17 (37.8%) unilateral on the left, and 14 (31.1%) bilateral. Ten (5.0%) patients had one or more encephaloceles, none of whom had a documented history of seizure in the electronic medical record. The incidence of such findings should be taken into account when identifying or treating such lesions as possible epileptogenic foci.