Worsening headaches for 6 months, cerebellar signs on clinical examination. Occasional expressive dysphasia. Exclude space occupying lesion.
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There is an isodense grey matter extraaxial lesion in the frontal region. The lesion is centered on the planum sphenoidale. Buckling of the white matter. The lesion displaces the anterior corpus callous - rostrum and genum. The lesion abuts the optic chiasm and pituitary stalk. There is displacement of the frontal horns of the lateral ventricle and associated hydrocephalus with enlargement of the lateral ventricles. There is minimal perifocal edema of the adjacent brain, predominantly of the right frontal lobe.
The appearance is most keeping with a meningioma in the anterior cranial fossa.
A CT scan was performed subsequently to assess bony detail of the anterior cranial fossa. Neurosurgical review and histology would be imminent in this case.
Meningiomas are the most common non-glial tumors of the central nervous system (CNS), accounting for between 16 and 20 % of all intracranial tumors1. Magnetic resonance imaging (MRI) is the modality of choice for the investigation of space occupying lesions such as meningiomas, providing superior contrast differentiation in all directional planes and usually the ability to differentiate between intra- and extra-axial lesions.
- 1. American Journal of Neuroradiology October 2008, 29 (9) 1630-1635; DOI: https://doi.org/10.3174/ajnr.A1170