Whats is the most frequent clinical presentation of this tumour?
Headache is the most frequent complaint.
What is the most common clinical finding?
Cerebellar signs, which occurs in about 70% of cases.
A large, left sided, exctra-axial, petroclival homogeneously enhancing mass lesion is seen, which measures (4.7X3.7X5.0 cm). The left ambient cistern is effaced by the lesion, which also invades the left Meckel's cave and compresses the left side of brain stem. Besides, there is evidence of the left cavernous sinus invasion along with encasement of the ipsilateral internal carotid artery (not invaded- its signal void is preserved). There is, also, significant contralateral displacement of the basilar artery. There is significant compression on the brain stem with contralateral right-ward displacement. No gross evidence of hydrocephalus. Dural tail sign is also seen.
Given the above mentioned appearances, petroclival meningioma is highly likely.