Large cerebellopontine angle meningioma with obstructive hydrocephalus

Case contributed by Mostafa Elfeky
Diagnosis probable

Presentation

Headache and dizziness.

Patient Data

Age: 65 years
Gender: Female

Large extra-axial dome-shaped dural-based mass lesion at left cerebellopontine angle with dural tail. It shows homogeneous texture with smooth surfaces, and no cystic changes. It is of isointense signal on T1, high signal on T2 and FLAIR.

It is resting on left internal acoustic meatus with minimal intracanalicular extension. Normal diameter of left intermal auditory canal with visualised intracanalicular VII and VIII nerves. Anteriorly, it shows extension to the left Meckel cave. Inferiorly it is encroaching upon left jugular foramen opening.

It is compressing the brainstem from left side and left cerebellar hemisphere causing moderate supratentorial hydrocephalus with mild periventricular oedema.

Case Discussion

A large extra-axial mass lesion, mainly located at the left cerebellopontine angle with wide dural base. MRI appearance is suggestive of left cerebellopontine angle meningioma. Yet, the Meckel cave extension makes trigeminal schwannoma another differential.

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