Clival meningioma

Case contributed by Amr Farouk
Diagnosis almost certain


Underwent ventricular shunting previously.

Patient Data

Age: 50 years
Gender: Female

A large prepontine extra-axial SOL is seen related to the posterior aspect of the clivus and extends into the left cerebellopontine angle. It is eliciting isointense signal to grey matter on both T1 and T2 sequences and demonstrates vivid contrast enhancement with enhancing meningeal dural base. In DWI and ADC images it show similar signal intensity to brain. It displaces the basilar artery and distorts the brain stem and results in compression of the fourth ventricle. The SOL is seen extending cranially to suprasellar cistern. No bony invasion. 

A ventricular shunt tube is noted with no supratentorial hydrocephalic changes.

Case Discussion

MRI picture is in keeping with a meningioma including  isointense signal to grey matter on T1 and T2 WIs, intense homogenous enhancement and dural tail.  

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

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