Presentation
Left oculomotor nerve (CN III) palsy.
Patient Data
Large well-circumscribed extra-axial mass centered on the left cavernous sinus with superior extension encasing the anterior clinoid process which shows hyperostosis. It displays an iso-to hypointense signal to cortical grey matter on T1, isointense signal on T2 and a slightly high signal on FLAIR, with no calcification or hemorrhagic component on GE sequence. The postcontrast sequences show a vivid homogeneous enhancement. Surrounding vasogenic edema with mass effect on the midline structures with subfalcine herniation. There is encasement with a reduced caliber of the terminal segment of the ICA as well as the M1 segment of the middle cerebral artery, which is well-demonstrated on the MRA 3D-TOF.
Case Discussion
MRI features most consistent with cavernous sinus meningioma encasing the terminal segment of the ICA and M1 segment of the middle cerebral artery.
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