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Clival meningioma

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Witnessed seizure. Underlying cause?

Patient Data

Age: 30
Gender: Male
mri

MRI BRAIN with contrast

1.6cm well defined homogenously enhancing extra-axial lesion arising from the upper aspect of the left side of the clivus.  Thin enhancing dural tail. This extends into the pre-pontine space with mild mass effect on the ventral aspect of the pons.

The lateral extent of the mass lies close to, without contacting the origin of the left trigeminal nerve.

The remainder of the intracranial appearances are normal.

Case Discussion

The MRI appearances are in keeping with a meningioma including a dural tail.  This is likely to have been an incidental finding in this patient.

 A clival meningioma is one of the more uncommon sites for this common pathology.  

The differential for clival masses is relatively short.

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