Features consistent with a planum sphenoidale meningioma, with involvement of the cisternal segment of the left optic nerve including optic chiasm. This is demonstrated by a T1 and T2 isointense mass, epicentre at the left planum sphenoidale.
There is homogenous avid enhancement post-contrast administration. No regional hyperostosis was detected.
There is a curvilinear extension and involvement of the cisternal segmental of the left optic nerve. Nodular involvement of the left optic chiasm. There is waisting at the level of the optic foramen, with no intraorbital extension of the meningioma. The left optic nerve does appear atrophic in comparison to the asymptomatic right-hand side, consistent with the history of total blindness left-sided.
There is otherwise normal intra-orbital enhancement post-contrast administration.
The optic foramen is non-expanded.
The meningioma appears inseparable from the proximal left A1 and M1 segments. No vascular encasement is however demonstrated, the vessels are eccentrically on the periphery of the lesion. No regional left ACA or MCA thrombosis was further identified.
There is mild regional mass effect with consequent appearance of an expanded sella turcica with a flattened pituitary gland and posteriorly displaced pituitary stalk.
Contrast-enhanced MR imaging of the brain is otherwise essentially normal. Time of flight MRA appears normal. No evidence of intracranial venous sinus thrombosis.