Presentation
Vertigo.
Patient Data
The MRI sequences demonstrate two well-circumscribed extra-axial dural-based masses:
the largest is of retroclival location extending to the cerebellopontine angle as well as to the ipsilateral cavernous sinus, encasing the basilar artery with reduced calibre as well as the intracavernous internal carotid artery. It shows an isointense signal to the cortical grey matter on T1 and T2, and high signal FLAIR with vivid homogeneous enhancement on post-contrast sequences. A mass effect is noted on the brainstem and cisternal portion of the ipsilateral trigeminal nerve
the other extra-axial mass is of the right basifrontal location showing the same signal intensity and enhancement with surrounding vasogenic oedema
Small vessel ischaemic change is noted.
Case Discussion
MRI features most consistent bifocal meningioma (basifrontal and retroclival extending to the ipsilateral cavernous sinus).
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