Presentation
Transient aphasia with blurred vision
Patient Data
Large left temporofrontal extra-axial mass with a broad-based attachment to the dura, invading the adjacent skull bone with a subgaleal component. It shows an iso-signal intensity on T1WI, high signal intensity on T2WI and FLAIR, iso-signal on DWI and iso-to high signal on ADC, surrounded by a thin rim of CSF "cleft sign". After IV contrast administration it shows an intense and relatively inhomogeneous enhancement especially of the endocranial component with "dural tail sign". A significant mass effect on the midline structures with dilated contralateral ventricular system.
Case Discussion
The differential diagnosis of an atypical meningioma invading the skull bone should include the hemangiopericytoma
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