Cerebellopontine angle meningioma

Case contributed by Dr Ian Bickle

Presentation

Middle aged patient presenting with right sided trigeminal neuralgia.

Patient Data

Age: 49
Gender: Female
Modality: CT

Enhancing well defined elliptoid mass centred on the right CP angle.

No bony destruction.

Modality: MRI

Well defined mildly high T1 and T2 hyperintense mass at the right CP angle with extension into the IAM.  No IAM expansion.

Avid contrast enhancement with a dural tail illustrated.

Mass effect and impingment on the trigeminal nerve at its origin.

Mass effect on the right crebellar hemisphere, brainstem and midbrain.

No hydrocephalus.

Case Discussion

Investigation for a cerebellopontine angle mass is part of the daily work of most radiology departments typically for sensioneural hearing loss.

The commonest pathology at this site is a vestibular schwammona.   One key differential is a meningioma, which although not pathognomonic, characteristically exhibits a dural tail.

In this case the patients symptoms were infact trigeminal neuralgia due to impingement of the 5th cranial nerve against the brainstem.

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Case Information

rID: 35181
Case created: 25th Mar 2015
Last edited: 15th Feb 2016
Tag: ravi
Inclusion in quiz mode: Included

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