Presentation
Middle aged patient presenting with right sided trigeminal neuralgia.
Patient Data
Enhancing well defined elliptoid mass centered on the right CP angle.
No bony destruction.
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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